Primary prevention of cardiovascular disease in South African women living with HIV

The colliding epidemics of HIV and cardiovascular disease (CVD) are of great public health concern. People living with HIV (PLHIV) are more predisposed to CVD development as a result of a multitude of contributors. Women living with HIV (WLHIV) appear to be at a higher risk of developing CVD given a heightened immune activation and, in South Africa particularly, a higher body mass index compared with their male counterparts. The World Health Organization (WHO) has made recommendations for the provision of a CVD risk assessment for all PLHIV and has developed regional CVD prediction charts to identify PLHIV who may require primary prevention strategies by means of interventions such as the WHO Package of Essential Non-communicable Disease Interventions for primary health care in low-resource settings (WHO PEN). However, methods of risk prediction and risk reduction integrated strategies for atherosclerotic CVD in PLHIV such as the WHO PEN, particularly in women who may have sex-specific risk factors and culture-specific perceptions of body image, remain a major research gap in developing countries. Further research is crucial in guiding primary health care policy in South Africa.