Introduction: Chronic non-communicable diseases (NCDs) constitute a health problem worldwide. This problem is particularly important in people living with human immunodeficiency virus (PLHIV) in sub-Saharan countries where the prevalence of NCDs is expected to increase due to the epidemio­logical transition of life spans for PLHIV as treatment outcomes for HIV continue to improve. This study is the first to assess the occurrence and quality of care (QoC) of NCDs in PLHIV and to identify the contextual issues underpinning the QoC in Lesotho – a sub-Saharan country with the second highest prevalence of HIV globally.
Material and methods: Based on the Donabedian (2005) model for assessing QoC, the study used a trian­gulation of quantitative patient responses on QoC of NCDs, their treatment outcomes and qualitative interviews with hospital staff in Maseru, Lesotho.
Results: Two hundred and forty-six PLHIV with a median survival time of 7 years since the first diagnosis of HIV (IQR: 3-9 years) and 25 hospital staff were included in the study. Forty-two percent (42%) of the patients had at least one diagnosed NCD, and 33% of these were diagnosed outside of the antiretroviral treatment (ART) centers. Overall, the QoC of NCDs was inadequate. Only 32% of patients with NCDs had records on NCD treatment outcomes in the ART centers. Shortage and disrepair of equipment, along with inadequate staff were the major barriers affecting the orga­nizational structure for the care of NCDs. Inadequate screening for NCDs, disintegrated checkup schedules for NCDs/HIV co-morbid conditions, and inadequate patient education were the major issues affecting the treatment processes.
Conclusions: The longer life spans of PLHIV in this study emphasises the need to scale up the diagnosis of NCDs while improving their QoC in PLHIV in Lesotho. The issues underpinning the QoC of NCDs should thus be prioritised in the interventions aimed at improving QoC of NCDs in PLHIV.