International Journal of Prevention and Treatment 2012, 1(4): 53-60
DOI: 10.5923/j.ijpt.20120104.01
Developing a Public Health Framework for the
Epidemiological Linkages between HIV/AIDS and NCDs:
A Thematic Research Synthesis
Tilahun Nigatu
1,*
, Geoffre y Sets we
2
, Julian Elliot
3
, Brian Olde nburg
1
1
Department of Epidemiology and Preventive Medicine, Monash University, Australia
2
School of Health Sciences, Monash University, South Africa
3
Infectious Disease Unit, Alfred Hospital, Australia
Abstract The Political Declaration of High-level Meeting of the General Assembly on the Prevention and Control of
NCDs has noted possible linkages between HIV/AIDS and NCDs. The aim of this study was to develop a public health
framework for those linkages between HIV/AIDS and the common NCDs. The overall method used in this study was a
thematic research synthesis. Descriptive, integrative and configurative syntheses of evidence on linkages between HIV/AIDS
and NCDs were conducted. The searching process was iterative; appraisal was stepwise; and extraction was verbatim. All
retrieved information was described, analysed and then configured in to a concept map using major pathways of relationships
between HIV/AIDS and NCDs. The concept map was developed in to the public health framework through progressive
review and revisions. Two major forms and pathways of linkages between HIV/AIDS and NCDs were identified. There are
five nodes that mediate the indirect HIV-NCD linkage: common underlying factors, life style factors, antiretroviral treatment,
common complications, and other mediating disease conditions. These linkages along with mediating factors are organized in
to a public health framework. In conclusion, the main pathways and forms of relationship between HIV/AIDS and NCDs
were described; and a public health framework for the epidemiological interrelationships between HIV/AIDS and NCDs was
developed.
Keywords Epidemiological Linkage, Public Health Framework, HIV/AIDS , NCDs
1. Introduction
After three decades in to the HIV epidemic, there are more
than 33 million People living with HIV (PLHIV), two third
of which are in sub-Saharan Africa. HIV/AIDS was a cause
for about 1.8 million deaths in 2010. In the same year, 2.1
million new HIV infections have occurred. About 90% of
these new HIV infections were in sub-Saharan Africa.
Globally, the incidence of HIV has decreased by about 19%
between 2001 and 2009. However, there is still dramatic
variability in the change in incidence rate in specific set-
tings[1]. About 7.2 million PLHIV are currently receiving
antiretroviral treatment (ART). A lot has also been invested
in the fight against this pandemic[2].
On the other hand, Noncommunicable diseases (NCDs)
are the major killers worldwide. About 36 million of the 57
million total global deaths in 2008 were due to NCDs. NCDs
cause three of the five deaths globally. The four common
* Corresponding author:
tilahun.haregu@monash.edu (Tilahun Nigatu)
Published online at http://journal.sapub.org/ijpt
Copyright © 2012 Scientific & Academic Publishing. All Rights Reserved
NCDs, Cardiovascular diseases (CVD), cancers, chronic
respiratory diseases (CRD), and Diabetes, account for about
80% of the total NCD deaths. The majority, 80%, of the total
NCD deaths occur in low-and-middle income countries.
About 30% of NCD deaths are among people below 60 years
of age[3]. The total NCD deaths are expected to reach 52
million if appropriate actions are not going to be taken. The
four common NCDs share four common risk factors: un-
healthy diet, insufficient physical activity, tobacco use and
harmful use of alcohol.
The possible linkages between HIV/AIDS and NCDs are
recognized at a higher level political declaration of the
United Nations General Assembly on NCDs. The General
assembly has acknowledged important linkages, associative
relations, between the two disease conditions. These impor-
tant linkages between HIV and NCDs are recommended for
consideration, as appropriate, in the integration of health
system responses to HIV/AIDS and NCDs[4]. The transla-
tion of these linkages in to the concept of integration of
interventions needs public health models that illustrate
broader perspectives of their relationships.
The interrelationship between HIV/AIDS and NCDs is
complex and multidimensional. It also has various impacts