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Population‐level decline in BMI and systolic blood pressure following mass HIV treatment: Evidence from rural KwaZulu‐Natal
Author(s) -
Geldsetzer Pascal,
Feigl Andrea B.,
Tanser Frank,
Gareta Dickman,
Pillay Deenan,
Bärnighausen Till
Publication year - 2017
Publication title -
obesity
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.438
H-Index - 199
eISSN - 1930-739X
pISSN - 1930-7381
DOI - 10.1002/oby.21663
Subject(s) - medicine , overweight , body mass index , anthropometry , obesity , population , blood pressure , demography , weight loss , human immunodeficiency virus (hiv) , gerontology , immunology , environmental health , sociology
Objective Clinic‐based studies have shown that patients with human immunodeficiency virus (HIV) gain weight after initiation of antiretroviral therapy (ART). This study aimed to determine whether the scale‐up of ART was associated with a population‐level increase in body mass index (BMI) and blood pressure (BP) in a community with high HIV and obesity prevalence. Methods A household survey was conducted in rural KwaZulu‐Natal before ART scale‐up (in 2004) and when ART coverage had reached 25% (in 2010). Anthropometric data was linked with HIV surveillance data. Results Mean BMI decreased in women from 29.9 to 29.1 kg/m 2 ( P = 0.002) and in men from 24.2 to 23.0 kg/m 2 ( P < 0.001). Similarly, overweight and obesity prevalence declined significantly in both sexes. Mean systolic BP decreased from 123.0 to 118.2 mm Hg ( P < 0.001) among women and 128.4 to 123.2 mm Hg ( P < 0·001) among men. Conclusions Large‐scale ART provision is likely to have caused a decline in BMI at the population level, because ART has improved the survival of those with substantial HIV‐related weight loss. The ART scale‐up may have created an unexpected opportunity to sustain population‐level weight loss in communities with high HIV and obesity prevalence though targeted lifestyle and nutrition interventions.