Neighborhood deprivation and cardiometabolic risk factors in people living with HIV in urban South Africa

Neighborhood deprivation has been shown in the United States to be associated with prevalence of chronic diseases, including cardiometabolic risk factors. The impact of neighborhood deprivation on people living with HIV in populations in sub-Saharan Africa is not well understood, and further, there are no studies exploring such associations with other comorbidities. Adult patients living with HIV (n = 22,253), who attended a public health clinic in nine ward areas of Johannesburg, South Africa, and completed an intake survey between 2022 and 2024, were included in the study. We used multi-level models to determine the association between the validated South African Index of Multiple Deprivation (SAIMD), a multi-dimensional tool that measures deprivation, with four cardiometabolic risk factors: body weight (kg), systolic blood pressure (SBP), elevated total cholesterol, and diabetes. In multivariable-adjusted models, neighborhood deprivation remained statistically significantly positively associated with SBP. The adjusted odds ratios (aORs) for indicators of poorly controlled SBP (>140 mmHg) revealed increases between the least and most deprived neighborhoods. In multivariable-adjusted models, higher levels of neighborhood deprivation were statistically significantly positively associated with indicators of cardiometabolic risk among adults living with HIV. These findings suggest that shared neighborhood level deprivation contributes to comorbid disease burden in PLWH.