Added socioeconomic burden of non-communicable disease on HIV/AIDS affected households in the Asia Pacific region: A systematic review

Sithara Wanni Arachchige Dona; Shalika Bohingamu Mudiyanselage; Jennifer J Watts; Rohan Sweeney; Ben Coghlan; Ishani Majmudar; Julie Abimanyi-Ochom

doi:10.1016/j.lanwpc.2021.100111

Added socioeconomic burden of non-communicable disease on HIV/AIDS affected households in the Asia Pacific region: A systematic review

Lancet Reg Health West Pac. 2021 Mar 2:9:100111. doi: 10.1016/j.lanwpc.2021.100111. eCollection 2021 Apr.

Authors

Sithara Wanni Arachchige Dona¹, Shalika Bohingamu Mudiyanselage¹, Jennifer J Watts¹, Rohan Sweeney², Ben Coghlan^{3

4}, Ishani Majmudar¹, Julie Abimanyi-Ochom¹

Affiliations

¹ Deakin Health Economics, School of Health and Social Development, Deakin University, Locked Bag 20000, Geelong, Victoria, 3220 Australia.
² Centre for Health Economics, Faculty of Business & Economics, Monash University, Caulfield East, Victoria, Australia.
³ Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
⁴ Centre for International Health, Burnet Institute, Melbourne, Victoria, Australia.

Abstract

Background: HIV/AIDS causes significant socioeconomic burden to affected households and individuals, which is exacerbated by non-communicable diseases (NCDs). The Asia Pacific Region (APR) comprises about 60% of the global population and has been significantly affected by HIV/AIDS with 5.8 million after Sub-Saharan Africa in 2019. We investigated socioeconomic impacts of HIV/AIDS alone and the added burden of NCDs on HIV-affected households (HIV-HHs) and individuals in the APR.

Method: We searched multiple databases for studies published in English over 30 years on socioeconomic impact of HIV/AIDS alone and HIV/AIDS with NCDs on affected households or individuals in APR. Findings were synthesised across six domains: employment, health-related expenditure, non-health expenditure, strategies for coping with household liabilities, food security, and social protection.

Findings: HIV-HHs had a significantly higher socioeconomic burden compared to Non-HIV households. Total household expenditure was lower in HIV-HHs but with higher expenditure on health services. HIV-HHs experienced more absenteeism, lower wages, higher unemployment, and higher food insecurity. There is a paucity of evidence on the added burden of NCDs on HIV-HHs with only a single study from Myanmar.

Interpretation: Understanding the socioeconomic impact of HIV/AIDS with and without NCD is important. The evidence indicates that HIV-HHs in APR suffer from a significantly higher socioeconomic burden than Non-HIV-HHs. However, evidence on the additional burden of NCDs remains scarce and more studies are needed to understand the joint socioeconomic impact of HIV/AIDS and NCDs on affected households.

Funding: Deakin University School of Health and Social Development grant and Career Continuity grant.

Keywords: HIV/AIDS; NCD/Chronic diseases in HIV-Households; Socioeconomic burden; The Asia Pacific Region.