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

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.