Predictors of AIDS-defining and Non-AIDS-defining Cancers Among PLHIV Accessing Services in Selected Hospitals in Nairobi City County, Kenya

Human infection with HIV compromises the immune system and reduces the body’s ability to fight viral infections that may promote the development of certain types of cancers. The diagnosis of AIDS-defining cancers in PLHIV indicates the progression of an HIV infection to the AIDS stage. Non-AIDS-defining cancers occur in HIV-positive individuals without necessarily being caused or exacerbated by HIV infection. WHO estimates that 39.9 million are PLHIV, whereas 42.3 million lives have been lost to HIV. Kenya’s HIV prevalence was 3.3% and in Nairobi, 4.3%. NCD mortalities in Kenya were 39%, including cancers, up from 27% and HIV remains a major risk factor. This study’s main purpose was to identify the predictors of AIDS-defining and non-AIDS-defining cancers among PLHIV accessing services in selected hospitals in Nairobi City County, Kenya. An analytical cross-sectional design was used. Study sites were purposively selected, whereas a simple random method was used to select 406 adults, aged 18 years and above, HIV positive and on ART. The study was conducted in seven selected facilities in Nairobi County. Quantitative data were collected using semi-structured questionnaires, whereas qualitative data were obtained from seven key informant interviews and three focus group discussions. Descriptive statistics (percentages, graphs, and charts) and inferential statistics (chi-square and logistic regression models) were performed using SPSS v. 27. Qualitative data were transcribed, coded, and grouped into themes. AIDS-defining cancers were the most prevalent (74.6%) among PLHIV accessing services in the selected hospitals. A Pearson’s Chi-square (X<sup>2</sup>) test revealed that socio-demographic characteristics such as sex (p = 0.00), age in years (45-54 for AIDS-defining cancer and 65 and above for Non-AIDS-defining cancers) (p = 0.00), marital status (married and widowers for ADC and NADC, p = 0.02) and level of education (secondary and ‘other’ for ADC and NADC respectively; p = 0.005) were associated with the type of cancer development among people living with HIV. A binary logistic regression model found that age (χ<sup>2</sup>(5) = 14.96, <i>p</i> = 0.011), income level (X<sup>2 </sup>(5) = 9.96; <i>p = </i>0.076), history of cigarette smoking (B = 1.53; <i>p </i>= 0.001; OR = 4.638; 95% CI: 2.28 – 9.42), alcohol consumption (B = 0.295; <i>p </i>= 0.356), family history of cancers (B = 1.04; <i>p </i>= 0.001; OR = 2.827; 95% CI: 1.61 – 4.97), were statistically associated with AIDS and non-AIDS-defining cancers. These findings will help formulate programmatic and policy interventions for ADC and NADC among PLHIV.