Task-shifted Adaptation of the WHO-PEN Intervention to Address Cardio-metabolic Complications in People Living With HIV in Zambia

Inclusion Criteria

• •Objective 1
• •Focus group discussion participants/implementation survey participants:
• •Inclusion:
• •18 years of age or older
• •non-physician professional or lay/peer health care worker (HCW) involved with HIV and/or NCD service delivery.
• •Key Informant Interview (KII) participants:
• •18 years of age or older
• •a senior Ministry of Health (MOH) policy maker or health official working at national level in Zambia involved in managing, coordinating, and/or overseeing health services for non-communicable diseases in Zambia.
• •In-depth interview participants:
• •emancipated HIV-infected adults 18 years of age or older have a documented cardio-metabolic condition
• •Exclusion:
• •any potential IDI, FGD, or KII participant if they are unwilling or unable to provide informed consent.
• •Objective 2:
• •Cross-sectional assessments:
• •Inclusion:
• •HIV-infected
• •aged 18 years and older
• •seeking care at either of the two ACHIEVE-supported pilot sites who are screened for and/or found to have evidence of one or more of the cardio-metabolic conditions or risk factors.
• •Nested cohort participants:
• •Inclusion:
• •documented HIV infection
• •aged 18 years or older
• •have one or more cardio-metabolic conditions or risk factors:
• •* obesity (defined as BMI \> 30 kg/m\^2);
• •* any current tobacco smoking;
• •* hypertension as defined by WHO PEN (i.e., systolic blood pressure (SBP) = 140 mmHg and/or diastolic blood pressure (DBP) = 90 mmHg);
• •* diabetes mellitus as defined by WHO PEN (i.e. random plasma glucose = 11.1 mmol/L, fasting plasma glucose = 7 mmol/L, and/or haemoglobin A1c = 48 mmol/mol);
• •* prediabetes (defined as having impaired fasting glucose of 6.1 to 6.9 mmol/L, impaired glucose tolerance with a two-hour, post-oral glucose tolerance test glucose =7.8 mmol/L but \<11.1 mmol/L and a fasting plasma glucose \<7.0 mmol/L, and/or haemoglobin A1c 42 to 48 mmol/mol); 6) dyslipidaemia (defined as total cholesterol \>4 mmol/L or low density lipoprotein =6 mmol/L); and/or 7) personal history or medication use for heart disease, heart failure, stroke, or other cardio-metabolic complication (including but not limited to coronary artery disease, cerebrovascular disease, myocardial infarction, stroke, or peripheral vascular disease).
• •IDI participants:
• •HIV-infected
• •18 years of age who were enrolled in the nested cohort and had documented exposure to the TASKPEN intervention at a pilot site.
• •FGD participants:
• •18 years of age or older
• •a non physician health care worker (NPHW) or community health worker (CHW)/ lay health provider involved with TASKPEN or integrated HIV/NCD service delivery generally familiar with HIV and/or NCD service delivery at their facility.
• •KII participants:
• •18 years of age or older
• •a facility-level antiretroviral therapy (ART) or out-patient department (OPD) clinic manager/ in-charge or policy maker at district, provincial, or national level in Zambia; and generally familiar with HIV and/or NCD-related issues in their community.