Integration of HIV/AIDS and noncommunicable diseases in developing countries: rationale, policies and models

Abstract

Background: HIV/AIDS and Noncommunicable disease (NCDs) are major public health problems in developing countries. An integrated approach of response to these problems is recommended. However, the evidence-base for such an approach is limited. The objective of this study was to consolidate evidence related to the rationale, the policy basis and models of HIV-NCD integration in developing countries.

Methods: Analysis of evidence related to the rationale for HIV-NCD integration, the policy basis for HIV-NCD integration, and models of HIV-NCD integration was conducted. As the evidence-base for HIV-NCD integration is very limited, a purposive and targeted search of the literature was used. Information was extracted using an abstraction tool. The extracted information was then aggregated and undergone qualitative synthesis under pre-defined themes.

Results: There is strong epidemiological, clinical and management related evidence relevant to the rationale for the integration of responses to HIV/AIDS and NCDs. Global declarations and strategies are in favour of integrated response to HIV/AIDS and NCDs. Types of models of HIV-NCD integration that were “tested” in the context of developing countries vary by contexts, disease combinations, types of services, and number of disease conditions involved. Despite these variations, all the models for which outcomes are available indicated that the integrated approach was feasible, effective, efficient and acceptable.

Conclusions: Evidence about rationale, policy bases and existing models of HIV-NCD integration from developing countries strongly favours integrated response. However, this is limited in breadth and depth. Therefore, more empirical evidence is needed to better inform decisions related to of HIV-NCD integration.