Objectives: Integration of HIV and non-communicable disease services improves the quality and efficiency of care in low- A nd middle-income countries (LMICs). We aimed to describe current practices for the screening and management of atherosclerotic cardiovascular disease (ASCVD) among adult HIV clinics in Asia. Methods: Sixteen LMICsites included in the International Epidemiology Databases to Evaluate AIDS-Asia-Pacific network were surveyed. Results: Sites were mostly (81%) based in urban public referral hospitals. Half had protocols to assess tobacco and alcohol use. Protocols for assessing physical inactivity and obesity were in place at 31% and 38% of sites, respectively. Most sites provided educational material on ASCVD risk factors (between 56% and 75% depending on risk factors). Atotal of 94% reported performing routine screening for hypertension, 100% for hyperlipidaemia and 88% for diabetes. Routine ASCVD risk assessment was reported by 94% of sites. Protocols for the management of hypertension, hyperlipidaemia, diabetes, high ASCVD risk and chronic ischaemic stroke were in place at 50%, 69%, 56%, 19% and 38% of sites, respectively. Blood pressure monitoring was free for patients at 69% of sites; however, most required patients to pay some or all the costs for other ASCVD-related procedures. Medications available in the clinic or within the same facility included angiotensin-converting enzyme inhibitors (81%), statins (94%) and sulphonylureas (94%). Conclusion: The consistent availability of clinical screening, diagnostic testing and procedures and the availability of ASCVD medications in the Asian LMICclinics surveyed are strengths that should be leveraged to improve the implementation of cardiovascular care protocols.
|Number of pages||8|
|Journal||Journal of Virus Eradication|
|Publication status||Published - 2020|
Bibliographical noteFunding Information:
DcB has received research funding from gilead sciences and is supported by a national health and Medical research council early career Fellowship (aPP1140503); Mgl has received unrestricted grants from Boehringer ingelhiem, gilead sciences, Merck sharp & Dohme, Bristol-Myers squibb, Janssen-cilag and ViiV healthcare, consultancy fees from gilead sciences, and data and safety monitoring board sitting fees from sirtex Pty ltd; ahs has received research funding and travel support from ViiV healthcare; OTn is supported by a national Medical research council clinician scientist award (MOh-000276). all other authors report no potential conflicts of interest.
The international epidemiology Databases to evaluate aiDs (ieDea) is supported by the national institute of allergy and infectious Diseases (100000060), the eunice Kennedy shriver national institute of child health and human Development (100009633), the national institute on Drug abuse (100000026), the national cancer institute (100000054) and the national institute of Mental health (100000025) in accordance with the regulatory requirements of the national institutes of health under award numbers U01ai069911 (east africa), U01ai069919 (West africa), U01ai096299 (central africa), U01ai069924 (southern africa) and U01ai069907 (asia-Pacific). The Kirby institute (data centre for the ieDea asia-Pacific) is funded by the australian government Department of health and ageing (501100001027) and is affiliated with the Faculty of Medicine, University of new south Wales (sydney, australia). This work is solely the responsibility of the authors and does not necessarily represent the official views of any of the institutions mentioned.
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All Science Journal Classification (ASJC) codes
- Public Health, Environmental and Occupational Health
- Infectious Diseases