Sociodemographic factors were associated with differing knowledge, attitudes, and practices for cardiometabolic risk reduction among people living with HIV, with adolescents showing higher knowledge and physical activity but poorer dietary practices and lower blood glucose screening uptake than adults.
Key Findings
Results
Adolescents living with HIV demonstrated higher knowledge of cardiometabolic risk factors than adults.
75.3% of adolescents had adequate knowledge of CMC risk factors compared to 55.9% of adults (p < 0.001)
98 adolescents (median age 17 years, IQR 14-19) and 390 adults (median age 41 years, IQR 32-49) were enrolled
Knowledge scores were categorized using modified Bloom's cut-off criteria
The survey was conducted from April to May 2025 across six randomly selected HIV care and treatment clinics in Dar es Salaam, Tanzania
Results
Lower educational attainment was associated with higher prevalence of low cardiometabolic knowledge among PLWH.
Participants with no formal education had a higher prevalence of low CMC knowledge compared to those with secondary education or higher (aPR = 2.08, 95% CI: 1.52–2.84)
Participants with only primary education also had higher prevalence of low CMC knowledge (aPR = 1.60, 95% CI: 1.22–2.09)
Associations were assessed using generalized Poisson mixed-effects regression models accounting for clustering by health facility
Results
Negative attitudes towards cardiometabolic prevention were more prevalent among participants in certain municipalities and among those who were divorced, separated, or widowed.
Participants attending clinics in Kigamboni Municipality had higher prevalence of negative attitudes than those in Ubungo Municipality (aPR = 1.39, 95% CI: 1.25–1.54)
Divorced, separated, or widowed participants had higher prevalence of negative attitudes than married or cohabiting participants (aPR = 1.45, 95% CI: 1.10–1.90)
These associations were identified using generalized Poisson mixed-effects regression models
Results
Adolescents reported higher physical activity levels than adults but demonstrated poorer dietary practices and lower uptake of blood glucose screening.
94.9% of adolescents reported adequate physical activity compared to 85.1% of adults (p = 0.01)
Adolescents had poorer dietary practices and lower blood glucose screening uptake than adults (all p < 0.001)
Physical activity was assessed using the Global Physical Activity Questionnaire
Results
Poor cardiometabolic-related practices were more prevalent among participants attending dispensaries than hospitals and among adolescents than adults.
Participants attending dispensaries had nearly twice the prevalence of poor CMC-related practices compared to those attending hospitals (aPR = 1.97, 95% CI: 1.67–2.32)
Adolescents had higher prevalence of poor CMC-related practices than adults (aPR = 1.73, 95% CI: 1.11–2.69)
The total study sample was 488 participants, with 51.0% female and 20.1% adolescents
Methods
The study enrolled 488 PLWH across six randomly selected HIV care and treatment clinics in Dar es Salaam, Tanzania using a facility-based cross-sectional design.
488 participants were enrolled: 51.0% (249) female, 20.1% (98) adolescents aged 13–19 years, and 79.9% (390) adults aged ≥20 years
Participants were recruited consecutively from April to May 2025
KAP were assessed using a questionnaire adapted from the WHO STEPwise approach and the Global Physical Activity Questionnaire
KAP scores were categorized using modified Bloom's cut-off criteria
What This Means
This research surveyed 488 people living with HIV (PLWH) — including both adolescents (ages 13–19) and adults — at HIV clinics in Dar es Salaam, Tanzania to understand their knowledge, attitudes, and health behaviors related to cardiometabolic conditions such as diabetes and heart disease. The study found notable differences between age groups and by social factors: adolescents actually knew more about cardiometabolic risk factors than adults, but were less likely to eat well, get their blood sugar checked, or engage in other preventive health practices. Adults reported more consistent healthy behaviors overall, though they had lower physical activity levels than adolescents.
The research also found that lower education levels, being divorced or widowed, attending lower-level health facilities (dispensaries rather than hospitals), and living in certain areas of the city were all linked to worse cardiometabolic knowledge, more negative attitudes toward prevention, or poorer health practices. These findings suggest that simply providing information may not be enough — the type of clinic, marital status, and community context all play a role in how PLWH engage with cardiometabolic health.
This research suggests that HIV care programs in Tanzania and similar settings should incorporate age-specific and socially tailored strategies to improve cardiometabolic health among PLWH. For adolescents in particular, interventions may need to focus less on knowledge (which appears relatively good) and more on translating that knowledge into healthy behaviors like better diet and routine health screenings. Strengthening services at lower-level facilities like dispensaries may also help close the gap in preventive care.
Karoli P, Shayo G, Kagaruki G, Hawkins C, Mayige M, Soka C, et al.. (2026). Knowledge, attitudes, and practices in cardiometabolic health among adolescents and adults in HIV care in Dar es Salaam, Tanzania.. Frontiers in public health. https://doi.org/10.3389/fpubh.2026.1851673