title: Body Mass Index and Waist Circumference in Patients with HIV in South Africa and Associated Socio-demographic, Health Related and Psychosocial Factors.
abstract: A high body mass index (BMI) and high waist circumference are important health risk factors predisposing for cardiovascular and metabolic diseases and certain cancers. Historically, underweight was a diagnostic criterion of HIV-infection. In a cross-sectional study the prevalence of BMI-categories and high waist circumference and its associated factors in patients visiting three outpatient HIV clinics in South Africa were measured with anthropometric measurements and structured questionnaires regarding socio-demographic information, quality of life (QoL), AIDS-related stigma, symptoms of depression, alcohol use, HIV related information and level of adherence to ART. The median age of the 2230 included patients was 37 years, 66.5% were women and 88.6% received antiretroviral therapy. The prevalences of overweight, obesity and high waist circumference were 29.2, 21.9 and 44.6% respectively in women and 12.4, 4.0 and 3.9% respectively in men. Underweight was found in 18.2% of men and 6.3% of women. In multinomial regression analysis compared to a normal BMI, both overweight and obesity were associated with female gender, with being married or cohabiting and with a higher QoL score. Underweight was associated with male gender and tobacco use and negatively associated with being married or cohabiting and the physical domain of the QoL measure. A high waist circumference in men was associated with higher age and negatively associated with tobacco use and stigma score. In women it was negatively associated with never being married. A high prevalence of overweight and obesity was observed in HIV-clinics in South Africa, mainly in women. Since overweight and obesity are important health risk factors, effective weight reduction interventions are desirable.
authors.affiliation: Department of Epidemiology and Social Medicine, University of Antwerp, Antwerp, Belgium. diana.huisintveld@uzgent.be.|FWO Research Foundation Flanders, Brussels, Belgium. diana.huisintveld@uzgent.be.|Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium. diana.huisintveld@uzgent.be.|Algemeen inwendige geneeskunde, De Pintelaan 185, 9000, Ghent, Belgium. diana.huisintveld@uzgent.be.
authors.forename: Diana
authors.identifier: http://orcid.org/0000-0002-5806-4352
authors.initials: D
authors.lastname: Huis In 't Veld
authors.affiliation: ASEAN Institute for Health Development, Mahidol University, Nakhonpathom, Thailand.|Department of Research and Innovation, University of Limpopo, Sovenga, South Africa.
authors.forename: Supa
authors.initials: S
authors.lastname: Pengpid
authors.affiliation: Department of Epidemiology and Social Medicine, University of Antwerp, Antwerp, Belgium.|Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
authors.forename: Robert
authors.initials: R
authors.lastname: Colebunders
authors.affiliation: ASEAN Institute for Health Development, Mahidol University, Nakhonpathom, Thailand.|HIV/AIDS, STIs & TB (HAST) Research Programme, Human Sciences Research Council, Pretoria, South Africa.|Department of Psychology, University of Limpopo, Sovenga, South Africa.
authors.forename: Karl
authors.initials: K
authors.lastname: Peltzer
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology; D019380:Anti-HIV Agents / Q000627:therapeutic use; D001530:Belgium / Q000453:epidemiology; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D050177:Overweight / Q000453:epidemiology; D015995:Prevalence; D011788:Quality of Life; D012307:Risk Factors; D013019:South Africa / Q000453:epidemiology; D011795:Surveys and Questionnaires; D064424:Tobacco Use / Q000453:epidemiology; D055105:Waist Circumference
chemical_list: D019380:Anti-HIV Agents
keywords: BMI; HIV; Psychosocial socio-demographic health related factors; South Africa