Self-care practices of people living with HIV and hypertension or diabetes comorbidities in low-and-middle income countries: A systematic review.

In 30 seconds

This systematic review synthesised qualitative research on self-care among people living with HIV and hypertension or diabetes in low- and middle-income countries. It included 13 studies from six African countries, with 458 participants; seven studies were rated high quality and six moderate. Five themes, supported with moderate-to-high confidence, covered how people understood illnesses and medicines, managed differing treatment approaches, adopted health-promoting behaviours, coped with distress, and navigated healthcare insecurity. Treatment burdens arose from prescribed tasks, disparities between HIV and comorbidity care, and efforts to compensate for gaps in care.

Key findings

• The review included 13 qualitative studies from six African countries, comprising 458 participants.
• Five themes had moderate-to-high confidence: illness and medication sense-making, divergent treatment approaches, health-promoting behaviours, coping with distress, and navigating healthcare insecurity.
• Treatment burdens were associated with prescribed care tasks, disparities between HIV and comorbidity care, and patient efforts to address gaps in hypertension or diabetes care.

Why it matters

Managing HIV alongside hypertension or diabetes can involve more than following multiple prescriptions: people also interpret differing treatment approaches, cope with psychosocial distress, and navigate gaps in care. Recognising these demands can help frame integrated care around patients’ lived experience, including the workload created by fragmented services and the need for clear, consistent support.

What to keep in mind

The evidence comprised qualitative studies from six African countries, so it does not quantify self-care workload or establish how widely the findings apply across all LMIC settings.