The South African Journal of Psychiatry publishes topical content in psychiatry for clinical practice and academic pursuits, including work in the subspecialty areas of psychiatry.

Background: People living with HIV (PLWH) are ageing, and face increased risk for developing Type 2 Diabetes. Physical activity and diet are effective in reducing Type 2 Diabetes risk. However, there is variation in how older PLWH engage in physical activity and healthy eating. Aim: To describe older PLWHs’ engagement in physical activity and diet for Type 2 Diabetes risk reduction in Harare Setting: The study was conducted in five polyclinics in Harare urban district from low socio-economic areas. Methods: A qualitative approach and an exploratory descriptive design was used. Twenty-three participants were selected purposively based on the researchers’ judgement of age among PLWH. Data were collected using a semi-structured interview schedule and analysed using Braun and Clark’s six steps of thematic content analysis. Ethical approval was obtained, and each participant provided informed consent. Results: The mean age of participants was 62 years. Participants performed varied physical activities through; economic activities, walking, exercise, and domestic chores. Diet included indigenous, unrefined grains, vegetables and fruit, influenced by rural background. Diet consisted of larger proportions of carbohydrates with lesser varying portions of protein and vegetables and fruit. Healthy eating among participants was facilitated by the proximity of markets and family. Conclusion: Health education to reduce Type 2 Diabetes risk should focus on fostering current physical activities to meet prescribed standards and increasing fruit and vegetable consumption. Contribution: The physical activity and diet self-care practices among older PLWH are inadequate in reducing Type 2 Diabetes risk, emphasising the need for appropriate health education.

Background: The effectiveness of antiretroviral therapy has enabled people living with human immunodeficiency virus (HIV) (PLWH) to live longer. With this longevity, there is the risk of developing age-related chronic conditions like Type 2 diabetes. Older PLWH have an increased risk of Type 2 diabetes mellitus (Type 2 DM) because of the natural physiological processes of ageing and risks posed by HIV infection and antiretroviral therapy use. The purpose of this scoping review is to describe risk factors associated with the development of Type 2 DM among older PLWH.Methods: The study adopted a framework for scoping reviews. The first step identified the research question, followed by identifying studies from three databases: PubMed, Mendeley and Cochrane Library. A total of 618 nonduplicate studies were screened, with a final selection of 15 full-text studies from 2012 to 2022. Data were extracted using the Souza (2010) data extraction tool and analysed numerically and with thematic content analysis.Results: Most studies were from Italy, with 60% being cross-sectional studies. On thematic analysis, the risks associated with Type 2 DM among older PLWH were long duration of HIV infection; the use of older-generation antiretroviral therapy; a high body mass index; the presence of hypertension and a lack of knowledge on modifiable risk factors for Type 2 DM.Conclusion: The identification of the risks that increase the likelihood of Type 2 DM among older PLWH facilitates effective screening and focused health education for older PLWH to reduce the development of Type 2 DM.Contribution: The findings of this study of excess risks of Type 2 DM specific to older PLWH complement risk factors of Type 2 DM in the general population. These excess risks facilitate case finding of older PLWH at risk of Type 2 DM especially in primary healthcare settings.

Background: Interventions for Type 2 Diabetes reduction among older people aged more than 50 years living with HIV (PLWH) are pertinent as they face excess risks amid a growing population of ageing PLWH. Aim: To describe interventions for Type 2 Diabetes reduction among older people living with HIV in Harare Urban District Setting: The study was conducted in a low socio-economic setting from five primary health care clinics in Harare urban District. Methods: A qualitative multi-method approach was applied using an exploratory descriptive design and an integrative review literature. The exploratory descriptive study collected data from two purposively selected samples; (1) older PLWH and (2) nurses. Whittemore and Knafl’s framework was used for the integrative literature review with articles from 2013 to 2023 selected. Data source triangulation was applied using Braun and Clark’s content analysis framework. Ethical approval was obtained (14056739_CREC_CHS_2022). Results: 23 older PLWH with mean age, 62 years, 9 nurses with an average of 6 years’ experience and 12 articles comprised the three data sources. Key themes that emerged were that, screening should include; assessment from a younger age; assessment of HIV and ART-specific risks; diagnostic testing of Type 2 diabetes tests at ART initiation and routinely. Health education should provide information on adequate physical activity parameters and increased consumption of fruits and vegetables. Metformin may be considered as a pharmacological intervention where lifestyle interventions fail. Conclusion: The proposed interventions suggest measures to reduce Type 2 Diabetes and mitigate excess risks faced by older PLWH. Contribution: Improved screening, health education and pharmacological interventions for older PLWH in primary health care settings enable Type 2 Diabetes reduction.

Background: There is an increase in non-communicable diseases (NCDs) in Africa, amid a high health worker shortage, necessitating task-sharing with community health workers (CHWs). However, task sharing with CHWs may not have positive patient outcomes, as they face several challenges. Aim: To describe the task-sharing challenges faced by CHWs in NCDs mitigation. Setting: Studies conducted in Africa were selected. Method: The Arksey and O’ Marley Framework was used. Included articles were published in English from 2015 to 2025. PubMed, ScienceDirect, and Google Scholar were searched from 26 March 2025. Two reviewers used Covidence to select studies, and conflicts were resolved through discussions. The researchers developed the data extraction tool and used content analysis to analyse data. Results: Articles screened by title were 189, with a final selection of 14 articles. The review found that an individual-level challenge was a lack of skills and inadequate knowledge. Organization-level challenges included a lack of supervision, a lack of equipment and infrastructure, and a poor referral system. Community-level challenges included safety concerns, poverty among community members, lack of transport, and mistrust of community health workers. Conclusion: It is essential to capacitate CHWs through continued supervision and training, and with policies that address broader socio-economic challenges like poverty and crime in Africa. Contribution: The study contributes to increasing the efficiency of the African CHWs by providing insights into the challenges they experience so that these challenges may be addressed.

Since 2005, the decline in HIV incidence has slowed down, and there is a need to optimise prevention services among young people to sustain and accelerate the HIV decline. This study aimed to describe HIV prevention practices among university students in South Africa. The Arksey and O’Malley Framework for conducting scoping reviews was used. South African studies that described the HIV prevention practices among university students, published in English from 2015 to 2025, were included. The search strategy was developed on the 8 December 2024, then on the 7 November 2025, and five databases were searched using key search terms: university students, HIV prevention, and South Africa. Two reviewers selected articles and extracted data using an extraction tool developed by the researchers. Extracted data was analysed using content analysis. Consultation was performed with students, conveniently selected from one university, and data was collected using interviews. Data from these students was analysed using Braun and Clarke’s thematic analysis. Thirteen studies were included in the review. Most (30.8%) were from KwaZulu-Natal province. A total of 15 students aged between 19 and 22 years were consulted. Most (53.3%) students were female. HIV prevention interventions used included HIV testing, which was sub-optimal due to stigma. Students also used condoms, although female condom use was minimal. Biomedical HIV prevention interventions used included post-exposure prophylaxis and pre-exposure prophylaxis, and these were used together with other HIV prevention interventions. Gaps remain to ensure optimal HIV prevention practices, and it is recommended that other biological HIV prevention methods like voluntary medical male circumcision, should be utilised.