Knowledge, attitudes and practices toward noncommunicable diseases and associated risk factors among people living with HIV in Rwanda: A cross-sectional study

Background The increasing burden of noncommunicable diseases (NCDs) globally poses a significant risk to people living with HIV (PLHIV). However, in Rwanda and other low- and middle-income countries, there is a lack of comprehensive understanding regarding PLHIV knowledge, attitudes, and practices (KAPs) related to NCDs. This study assessed the level of KAPs toward NCDs and related risk factors among PLHIV in Rwanda. Methods We conducted a cross-sectional study nested within an ongoing cohort between March and September 2021. A total of 1,334 PLHIV aged 18 years or older without a prior NCD diagnosis were randomly selected from 12 health facilities across five Rwandan provinces. Data were collected via a standardised KAP questionnaire. The KAP scores were evaluated relative to the maximum achievable scores via Likert scales. Descriptive statistics were used to summarise the findings, and linear regression was used to identify factors influencing KAP outcomes. Results The analysis included 1,170 participants, of which 63.8% were women, including 73.1% in the reproductive age group of 24–54 years. The majority were married (55.1%), nearly half (49.1%) had completed primary education, 39.1% were illiterate, and only 17.4% were unemployed. The study revealed low awareness and suboptimal practices concerning NCDs among PLHIV. While awareness of diabetes was relatively high, large proportions of participants were unaware of stroke (79.1%), heart disease (70.3%), or hypertension (54.7%). Furthermore, 21.9% lacked awareness of NCD risk factors, and 37.2% lacked knowledge of metabolic risk factors. The attitudes reflected misconceptions, with 36.3% believing that NCDs are inevitable and with 71.0% showing no concern about the quantity of salt intake. With respect to practices, 57.1% of the participants reported no routine health check-ups, and 47.9% did not maintain a healthy weight. Education, occupation, and BMI significantly influenced knowledge scores. Participants with above-secondary education scored 16.1 points higher, and those with obesity scored 3.6 points higher than their counterparts with no formal education or normal BMI (p = 0.002, 95% CI: 1.3–6.1). Conclusion Our findings highlight significant gaps in KAPs related to NCDs among PLHIV in Rwanda. Evidence-based and context-appropriate interventions, including health education, are needed to improve awareness and promote preventive behaviours among PLHIV, contributing to reducing NCD risk and fostering a healthier and more sustainable quality of life for PLHIV.