Gaps in diabetes care among people living with HIV and hypertension in Botswana: A cross‐sectional analysis of the InterCARE study

Abstract Objectives Data on diabetes screening and monitoring, within HIV care programmes in sub‐Saharan Africa, remain limited. This study describes the quality of diabetes screening and management among people living with HIV with comorbid hypertension receiving care at facilities participating in the InterCARE trial in Botswana. Methods We conducted a cross‐sectional analysis of adults aged 20–75 years with a documented diabetes diagnosis at enrolment in InterCARE (January–September 2023). All participants were people living with HIV with hypertension receiving routine HIV clinic care. Descriptive statistics were used to summarize baseline characteristics and key diabetes care indicators, including glycated haemoglobin (HbA1c), low‐density lipoprotein (LDL) cholesterol and blood pressure (BP), and their level of control. Results Of 4655 InterCARE participants, 138 (3.0%) had a prior diabetes diagnosis. In this diabetes subgroup, 69.6% were female ( n  = 99), and the median age was 58 years (IQR 52–64). Among the 87 participants receiving diabetes treatment, 80.0% ( n  = 70) were on oral agents and 20.0% ( n  = 17) on insulin‐based therapy. Glycaemic and LDL monitoring had been performed in only 5.1% and 2.2% of participants, respectively. Blood pressure control (BP n  = 75.1%), only 28.6% ( n  = 2) had glycaemic control (HbA1c Conclusion Diabetes care among people living with HIV ith hypertension in Botswana is suboptimal with major gaps in screening and metabolic monitoring. These findings highlight broader challenges in the delivery of integrated chronic disease care within HIV services. Strengthening the integration of non‐communicable disease care into HIV programmes, including routine diabetes screening and cardiometabolic risk management, is urgently needed to improve health outcomes and reduce the burden of cardiovascular and other chronic complications among people living with HIV.