Community-Based Screening and Referral Program for Diabetes, Hypertension, and Obesity Among People Living with HIV in Homa Bay County, Kenya

• Both HIV/AIDS and non-communicable diseases (NCDs) are major public health threats, affecting millions of people across the African continent. An estimated 1.33 million people are living with HIV, with a prevalence of approximately 3.0% in Kenya. Homa Bay County alone is a home to approximately 104,000 people living with HIV, representing one of the largest county-level HIV populations in the country. The Kenyan HIV data can be accessed through the National Syndemic Disease Control Council website: https://analytics.nsdcc.go.ke/estimates/#!/.
• Advances in antiretroviral therapy (ART) have significantly improved survival among people living with HIV (PLHIV). However, non-communicable diseases (NCDs), particularly hypertension, diabetes mellitus, overweight, and obesity, have emerged as major causes of morbidity and mortality within this population (Moyo-Chilufya et al., 2023). Chronic inflammation, long-term ART exposure, ageing, and poor nutrition all contribute to increased cardiometabolic risk in this population.
• The recent reduction in international HIV funding, especially by USAID has further strained community-based prevention and support programmes, limiting access to nutritional support, health promotion, and routine screening services. As a result, many PLHIV remain undiagnosed for hypertension and diabetes until complications such as stroke, heart disease, kidney failure, or blindness occur.
• Despite the exceptionally high HIV burden in Homa Bay County, routine NCD screening remains inadequately integrated into HIV care, particularly at the community level. This represents a missed opportunity for early diagnosis, prevention, and timely treatment. Moyo-Chilufya et al. suggested that NCD risk factors such as obesity, poor diet, and sedentary lifestyle among this population can be addressed through early diagnosis, national education, and health promotion campaigns. Thus, there is a need for such initiatives to mitigate the burden of NCDs among PLHIV in Kenya.
• This project seeks to address this critical gap by integrating community-based screening and health promotion campaigns for hypertension, diabetes, and obesity into existing HIV outreach services in Homa Bay county. Through collaboration with Involvement Volunteers International (IVI), Australia, Community Health Promoters (CHPs), Community Health Volunteers (CHVs), local health facilities, churches, schools, and community leaders, the project will improve early detection, strengthen referral systems, and promote integrated HIV-NCD care.

Program Objectives

• To conduct community-based screening for diabetes, hypertension, and obesity to identify individuals at risk.
• To increase awareness of NCDs and their risk factors, especially among populations affected by HIV through education and health campaigns.
• To establish integrated HIV–NCD care pathways for future effective screening, referral, and continuity of care for NCDs among people living with HIV in Homa Bay County.

Expected Outcomes

• Screen approximately 4,500 people living with or affected by HIV.
• Conduct 20 community outreach screening events.
• Train 30 Community Health Volunteers and Community Health Promoters.
• Provide NCD education to over 2,000 community members.
• Refer over 80% of participants with abnormal findings to appropriate health facilities.
• Develop a county-level program to support integrated HIV-NCD planning.