Online Reporter
Tendai Gukutikwa
Health Reporter
WITH the country having surpassed the global UNAIDS 95-95-95 targets, priority is no longer solely at ensuring that people know their HIV status and remain on treatment, but protecting them from chronic illnesses like hypertension, diabetes, cancer and mental health disorders, health specialists have said.
Speaking during a media engagement, Organisation for Public Health Interventions and Development (OPHID) senior technical adviser, Dr Tafadzwa Bepe said the country’s success means more people living with HIV are surviving into older age, and leading productive lives, creating an urgent need for the health system to address long-term chronic conditions alongside HIV.
“People living with HIV are now living normal lives. What this means is that we need to move towards a platform that also looks at chronic diseases. Non-communicable diseases are really the next frontier in HIV care,” said Dr Bepe, adding that HIV care should no longer be viewed simply as providing antiretroviral medicines, but as ensuring people maintain a good quality of life throughout adulthood.
“The HIV story is no longer just about access to antiretroviral therapy. We now need to ask whether the services we provide can sustain the quality of life of people who are on lifelong treatment,” he said, adding that people living with HIV face a higher risk of developing several non-communicable diseases because HIV causes chronic inflammation that can damage blood vessels and organs, particularly before the virus is fully suppressed.
“HIV itself results in what we call a chronic inflammatory condition. It affects the integrity of blood vessels and some of the body’s organs. That chronic immune activation increases the risk of developing several non-communicable diseases,” said Dr Bepe, adding that hypertension remains the leading non-communicable disease affecting people living with HIV, followed by diabetes, depression, anxiety and certain cancers.
“Women living with HIV, for example, have a higher risk of developing cervical cancer. That is why cervical cancer screening remains a critical component of HIV services,” said Dr Bepe, dismissing common misconception used to justify avoiding HIV prevention methods such as pre-exposure prophylaxis (PrEP).
“HIV causes damage long before treatment suppresses the virus. That damage increases a person’s risk of developing chronic illnesses later in life,” he said, urging the public to undergo regular screening for hypertension, warning that the condition often develops silently without symptoms until life-threatening complications occur.
“Many people believe they must first feel sick before they have hypertension, but that is not true. Someone can be walking around normally and then suddenly suffer a stroke because they never knew they had high blood pressure,” he said, adding that blood pressure readings consistently above 140/90 millimetres of mercury require medical attention, while even readings slightly below that level should prompt lifestyle changes and close monitoring.
Dr Bepe said an estimated one in every three adults has hypertension, while many remain unaware of their condition.
“One of the biggest challenges is that many hypertensive patients do not know their status, and even among those diagnosed, many do not know whether their blood pressure is under control,” he said, identifying ageing, physical inactivity, excessive alcohol consumption, smoking, obesity, high salt intake and family history as major risk factors.
Dr Bepe also challenged the widespread belief that some commercially marketed beverages are healthier than soft drinks simply because they are fruit-based.
“When you read the nutritional information, you may be surprised. Some fruit drinks actually contain very high amounts of sodium. We encourage people to start reading food labels so they understand what they are consuming,” he said.
Beyond the diseases, Dr Bepe said managing both HIV and chronic illnesses places a significant burden on patients, many of whom must attend multiple clinics on different days for different conditions. He said patients often spend hours queuing for HIV services before joining another queue for treatment of hypertension or diabetes.
“Imagine someone living with HIV who is also diabetic or hypertensive. They have to decide which queue to join first. If they rely on daily wages, every extra visit to the clinic means losing income,” he said. He said the cost of transport, repeated clinic visits, medicine shortages and conflicting review dates often force patients to prioritise one condition over another.
Dr Bepe said separate HIV and NCD services also place additional pressure on already stretched health workers and health facilities.
To address these challenges, he said the Ministry of Health and Child Care is moving towards integrated service delivery, allowing patients to receive HIV and chronic disease care during the same visit.
“The goal is to align HIV and NCD appointments so that patients receive comprehensive care on one day instead of making repeated trips to the health facility,” he said.
Dr Bepe said community health workers are also playing an increasingly important role in detecting hypertension early by conducting blood pressure screening within communities before referring patients requiring treatment. He said pilot programmes supported by OPHID demonstrated that community-based screening identified large numbers of undiagnosed hypertensive patients, particularly among older adults.
“As people get older, the risk of hypertension increases significantly. Community screening is helping us identify patients much earlier before complications develop,” he said.
