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Overweight and obesity are major global public health concerns, and they are increasingly recognized as side effects of long-term antiretroviral therapy (ART) in people living with HIV (PLHIV). As ART improves life expectancy, weight gain and associated comorbidities have emerged as new challenges in HIV care. This study aimed to determine the prevalence and associated factors with overweight and obesity among people living with HIV(PLHIV) on antiretroviral therapy (ART) in Benin’s National Teaching Hospital. A prospective cross-sectional study was conducted over a three-month period, from December 17, 2023, to February 10, 2024. Data were collected through structured interviews and medical record reviews. Statistical analyses included descriptive statistics, univariable, and multivariable logistic regression to assess associations between overweight/obesity and demographic, clinical, and lifestyle factors. The prevalence of overweight and obesity in the study population was 49.4%, with a significantly higher prevalence in females (36.8%) than males (12.6%). Multivariable analysis identified female sex (aOR: 2.4; 95% CI: 1.5–4.1; p  < 0.001) and hypertension (aOR: 2.5; 95% CI: 1.6–4.1; p  < 0.001) as strong independent predictors of overweight and obesity. Conversely, a high viral load (> 1000 copies/ml) was inversely associated with excess weight (aOR: 0.4; 95% CI: 0.2–0.9; p  = 0.050). In summary, nearly half of PLHIV on ART were overweight or obese. Female sex and hypertension increased the risk, while high viral load was linked to lower weight. These findings underline the need for integrated care approaches that address weight management in HIV treatment programs.

Background Although the high burden of both active smoking and human immunodeficiency virus (HIV) is clearly known, the relationship between them is still not well characterized. Therefore, we estimated the global prevalence of active smoking in people living with HIV (PLHIV) on antiretroviral therapy (ART) and investigated the association between exposure to active smoking and risk for suboptimal adherence to ART. Main text: We searched PubMed, Embase, and Web of Science to identify articles published until September 19, 2019. Eligible studies reported the prevalence of active smoking in PLHIV on ART or investigated the association between active smoking and ART adherence; or enough data to compute these estimates. We used a random-effects model to pool data and quantified heterogeneity ( I 2 ). The global prevalence of active smoking was 36.1% (95% CI : 33.7–37.2; 329 prevalence data; 462 104 participants) with substantial heterogeneity. The prevalence increased with level of country income; from 10.1% (95% CI : 6.8–14.1) in low-income to 45.2% (95% CI : 42.7–47.7) in high-income countries; P  < 0.0001. With regards to the Joint United Nations Programme on HIV/AIDS (UNAIDS) regions, the prevalence was higher in West and Central Europe and North America 45.4% (42.7–48.1) and lowest in the two UNAIDS regions of sub-Saharan Africa: Eastern and Southern Africa 10.7% (95% CI : 7.8–14.0) and West and Central Africa 4.4% (2.9–6.3); P  < 0.0001. Globally, we estimated that there were 4 110 669 PLHIV on ART who were active smokers, among which the highest number was from Eastern and Southern Africa (35.9%) followed by Asia and the Pacific (25.9%). Active smoking was significantly associated with suboptimal ART adherence: pooled odds ratio 1.57 (95% CI : 1.37–1.80; I 2  = 56.8%; 19 studies; 48 450 participants); even after considering adjusted estimates: 1.67 (95% CI : 1.39–2.01; I 2  = 53.0%; 14 studies). Conclusions This study suggests a high prevalence of active smoking in PLHIV on ART and an association between active smoking and ART suboptimal adherence. As such, healthcare providers and policy makers should focus on adopting and implementing tobacco harm reduction strategies in HIV care, especially in sub-Saharan Africa known as epicenter of HIV pandemic with highest number of active tobacco smoking among PLHIV on ART.

Background Sleep disturbances are increasingly recognized as a significant yet often overlooked burden among people living with HIV (PLHIV). Thus, our study aims to assess the prevalence of poor sleep quality and investigated the associated factors among PLHIV on antiretroviral therapy (ART). Methods We conducted a hospital-based cross-sectional study from December 17th, 2023 and November 22nd,2024. A total of 514 PLHIV treated at the Centre National de Référence de Recherche et de la Prise en Charge du Sida (CNRRPEC) of the National University Hospital Center Hubert Koutoucou Maga (CNHU-HKM) in Cotonou, Benin were included in the final analysis. Sleep quality of the participants was investigated using the Pittsburg Sleep Quality Index (PSQI). Binary logistic regression analysis was performed to identify factors associated with poor sleep quality. In the multivariable analysis, variables with p -values less than 0.05 were considered statistically significant, with a 95% confidence interval. Results A total of 514 patients (349 women and 165 men) were enrolled in this study. The mean age of enrolled patient was 43.1 ± 12.6years, and 73.9% reported alcohol consumption. Most patients had been on antiretroviral therapy for more than five years. 47.9% of our patients experienced poor sleep quality in our study. World Health Organization (WHO) initial stage was significantly associated with poor sleep quality. Conclusion This study highlights the importance of sleep quality in the overall management of HIV and proposes strategies to improve treatment outcomes and quality of life of patients. Regular assessment and appropriate management of factor affecting sleep quality can significantly contribute to the improvement of PLHIV's health and well-being.

Depression and anxiety are common comorbidities among people living with HIV (PLHIV) and may be influenced by sleep quality; evidence from Benin remains limited. We assessed the prevalence of depression and anxiety among PLHIV on antiretroviral therapy (ART) and evaluated their association with sleep quality. We conducted a hospital-based cross-sectional study at Benin's National Teaching Hospital from December 2023 to February 2024. Adults on ART ≥ 6 months were randomly sampled from the clinic registry. Validated tools were used: Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7, moderate-or-worse threshold ≥ 10; Pittsburgh Sleep Quality Index, poor sleep > 5. Multivariable logistic regression identified factors independently associated with depression and anxiety. Among 312 participants (68.3% female; mean age 44.3 ± 12.3 years), the prevalence of depression and anxiety was 20.8% (n/N = 65/312) and 12.8% (n/N = 40/312), respectively; poor sleep quality was common (57.1%, n/N = 178/312). Good sleep quality was independently protective for both depression with adjusted odds ratio (aOR) = 0.3, 95% confidence interval (CI) = 0.2-0.6 and anxiety (aOR = 0.4; 95% CI = 0.2-0.9). Age ≥ 44 years was associated with higher odds of anxiety (aOR = 2.1; 95% CI = 1.0-4.5), while other sociodemographic and clinical covariates were not independently associated. Moderate-or-worse depressive and anxiety symptoms are frequent among PLHIV in this setting, and sleep quality shows a robust independent association with both outcomes. Integrating routine mental-health and sleep screening with clear referral pathways within ART services is warranted; longitudinal and interventional studies should test whether improving sleep reduces symptoms and enhances ART outcomes.