Characteristics of pregnant women living with HIV/AIDS and gestational diabetes mellitus in the Chris Hani District, Eastern Cape Province

Characteristics of pregnant women living with HIV/AIDS and gestational diabetes mellitus in the Chris Hani District, Eastern Cape Province | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Characteristics of pregnant women living with HIV/AIDS and gestational diabetes mellitus in the Chris Hani District, Eastern Cape Province Dineo Olefile Tsheole, Nokwanda Edith Bam, Kgomotso Mathope This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9315119/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 6 You are reading this latest preprint version Abstract Background The coexistence of HIV/AIDS and Diabetes Mellitus (DM) during pregnancy creates unique challenges that elevate the risk of adverse outcomes for both mothers and newborns. Understanding the characteristics of women living with both conditions is crucial for developing targeted nursing interventions and enhancing antenatal care. Objective This study aimed to describe the demographic, clinical, and lifestyle characteristics of pregnant women living with both HIV/AIDS and DM in the Chris Hani District, Eastern Cape Province (ECP). Methods A quantitative research approach was employed, utilising a cross-sectional descriptive design within a pilot study framework. The pilot study was conducted to assess the feasibility of investigating the demographic, clinical, and lifestyle characteristics of pregnant women living with both HIV/AIDS and diabetes mellitus (DM) in the selected hospitals. The study was conducted in two hospitals in the Chris Hani District of the Eastern Cape Province and included 45 purposively selected pregnant women diagnosed with both HIV/AIDS and DM. The pilot design allowed for preliminary exploration of associations between participant characteristics and health outcomes, while also identifying potential challenges in data collection and measurement that could inform future larger-scale studies. Data were collected using a WHO STEPwise questionnaire and analysed using the Statistical Package for the Social Sciences (SPSS) version 31.0 to identify correlations between participant characteristics and the incidence of DM and HIV/AIDS. Results The study examined factors affecting immune function in HIV/AIDS-positive women. It found that moderate sports participation, blood pressure awareness, and blood pressure medication use were linked to improved CD4 counts, indicating enhanced immune function. However, no significant associations were noted between lifestyle factors, transportation modes, or blood pressure status and antiretroviral (ARV) complications or viral load, likely due to limited sample sizes and missing data. Diabetes Mellitus (DM) emerged as the most common ARV complication across all groups. These findings highlight the importance of moderate physical activity and chronic disease management in supporting the immune health of women living with HIV/AIDS. Conclusion Women with HIV/AIDS in this study, particularly those aged 26 to 35, were more likely to have DM. The use of blood pressure medications and elevated viral loads was associated with increased metabolic risk. These findings suggest the potential value of early screening, consistent monitoring, and integrated care to address both HIV and DM, which may help improve outcomes for mothers and their infants. Diabetes mellitus HIV/AIDS Eastern Cape pregnancy pilot study cross-sectional design What is already known about this topic? Pregnant women living with HIV are at an elevated risk for adverse outcomes affecting both maternal and neonatal health. The increasing prevalence of GDM is a significant global concern, as it contributes to complications such as pre-eclampsia, preterm delivery, and neonatal health issues. While each of these conditions is well-documented independently, there is a lack of evidence regarding their combined impact in South African hospital settings, particularly in the Eastern Cape, where maternal health challenges remain high. What does this paper add to the currently published literature? This research offers new insights from two selected hospitals in the Chris Hani District of Eastern Cape Province, focusing on the demographic, clinical, and socio-behavioural characteristics of pregnant women living with both HIV/AIDS and GDM. It highlights the complex challenges these women face, including limited access to integrated antenatal care and the dual burden of both infectious and non-communicable diseases. The findings provide valuable, locally relevant evidence within the literature, especially in a rural South African context, where these conditions significantly influence maternal health outcomes. What is the most important implication for BMC Pregnancy and Childbirth? The research highlights the pressing need for early screening and integrated antenatal care in hospitals across the Eastern Cape to effectively address both HIV and GDM. It provides relevant data that can inform policy development and maternal health programs aimed at minimising risks in pregnancies affected by both conditions. By focusing on at-risk women in a resource-limited rural setting, this study contributes to the Journal’s mission to promote safer and more equitable childbirth worldwide. Introduction Pregnancy is a critical period during which maternal health conditions can affect both maternal and infant outcomes [ 2 ]. Two major challenges are diabetes mellitus (DM) and HIV/AIDS. Globally, DM affects around 14% of pregnancies, with the highest prevalence in low- and middle-income countries [ 3 , 4 ]. DM during pregnancy is used to describe hyperglycaemia diagnosed during pregnancy or pre-existing diabetes identified during pregnancy[ 3 ]. HIV/AIDS remains a significant public health issue, particularly in sub-Saharan Africa, where maternal prevalence is among the highest worldwide. In South Africa, an estimated 27% of pregnant women are HIV positive, most receiving lifelong antiretroviral therapy (ART) as part of Prevention of Mother-to-Child Transmission (PMTCT) [ 6 , 7 ]. Both HIV/AIDS and DM are associated with adverse maternal and infant outcomes. DM during pregnancy increases the risk of preeclampsia, caesarean section, macrosomia, and neonatal hypoglycaemia, and may predispose mothers and newborns to long-term metabolic conditions [ 8 , 10 ]. Maternal HIV/AIDS infection is linked to low birth weight, preterm delivery, increased infection risk, and psychosocial stressors [ 11 , 14 ]. Although both conditions may share biological mechanisms such as immune dysfunction and altered metabolism [ 9 , 10 ], limited research has examined pregnant women who concurrently experience HIV/AIDS and DM, particularly in South Africa [ 5 , 7 , 14 ]. The Chris Hani District in the Eastern Cape Province was selected due to its high HIV/AIDS prevalence, emerging DM in pregnancy burden, and limited access to quality healthcare [ 7 , 14 , 15 ]. Understanding the demographic and clinical characteristics of pregnant women living with both conditions can inform integrated maternal healthcare strategies. Therefore, this study aimed to describe the characteristics of pregnant women living with HIV/AIDS and GDM in Chris Hani, providing evidence to support targeted interventions, resource allocation, and maternal health policy in high-burden settings. Therefore, this study aimed to describe the demographic and clinical characteristics of pregnant women living with HIV/AIDS and GDM in Chris Hani District, Eastern Cape. Specifically, the study sought to quantify these characteristics and examine associations between selected sociodemographic and clinical factors and the occurrence of GDM among women living with HIV/AIDS. Methodology This study employed a quantitative, cross-sectional descriptive design within a pilot study framework. Data were collected using a structured WHO STEPwise questionnaire administered face-to-face. Participants with missing viral load data were excluded from analyses involving viral load, and the proportion of missing values was reported. Descriptive statistics and Chi-square tests were used to examine associations between participant characteristics and outcomes. No adjustments were made for multiple comparisons, as this was a pilot study and analyses were exploratory. A sample size of 45 participants was considered adequate to provide preliminary data on participant characteristics and feasibility, which will inform sample size calculations and study design for a subsequent larger study. The term diabetes mellitus (DM) during pregnancy was used, as the duration reported reflects time since diagnosis and may extend beyond a single pregnancy period. This study was conducted as a pilot study to assess feasibility, data collection processes, and preliminary associations. Therefore, a smaller sample size (n = 45) was considered appropriate for exploratory analysis rather than hypothesis testing. Study site This study was conducted in the Chris Hani District Municipality in the Eastern Cape Province (ECP) of South Africa. The ECP consists of two metropolitan municipalities, namely Buffalo City Metropolitan and Nelson Mandela Metropolitan Municipality, along with six districts: Amathole, Joe Ggapi, O.R. Tambo, Sarah Baartman, Chris Hani, and Alfred Nzo. The research primarily took place in two hospitals that serve a high number of pregnant women living with HIV/AIDS and DM. In Chris Hani, there are five primary healthcare clinics and two hospitals: Burgersdorp Clinic, Ngcobo Clinic, Rietvlei Clinic, Zingcuka Clinic, Wepener Clinic, Cofimvaba Hospital, and All Saints Hospital. These two Hospitals are the largest central hospitals in the area, offering a broader range of services and more resources than the primary healthcare clinics. Therefore, these hospitals were chosen for the pilot study due to their high volume of pregnant women living with HIV/AIDS and DM. Study Population The study population consisted of pregnant women residing in two selected hospitals during the survey period. A systematic random sampling method was employed to ensure a representative sample because it is simple, time- and cost-efficient, and ensures an evenly distributed sample [ 16 ]. It reduces selection bias when the population list is random and is practical for a large population [ 16 ]. The initial stage involved identifying the geographical area through a systematic and random approach to participant selection using sampling frames. For this pilot study, a total of 45 pregnant women living with both HIV/AIDS and DM were included to evaluate the study procedures. The sample size was determined using the single population proportion formula n = (Zα/2)2p(1-p)/d2, based on the following assumptions: a 95% confidence level (Z = 1.96), an expected prevalence of 50% (p = 0.5), and a margin of error of 15%(d = 0.5). Based on these parameters, the required sample size was calculated to be 45 participants. Measures Data were collected using a structured questionnaire administered face-to-face in languages spoken locally, including English and isiXhosa, by the researcher and trained research assistants, with daily supervision and quality assurance checks provided by the research team lead. The questionnaires were developed and piloted to ensure that participants understood them. The tool was given to 3 participants to answer questions, and feedback was used to determine the need for modification. The questionnaire included three sections: demographic and behavioural measurements (age, education, ethnicity, marital status, pregnancy status, diet, physical activity, work, history of blood pressure, and history of diabetes), physical measurements (height, weight, waist circumference, blood pressure, and pulse), and biochemical measurements (blood glucose, blood lipids, CD4 count, viral load, and antiretroviral therapy regimen). All self-reported data were verified against clinical records where applicable, to ensure accuracy. These measures were used to assess the characteristics and health status of the study population and to refine study procedures before the main research. Data Analysis The data collected from participants was first organised and reviewed using Microsoft Excel. Subsequently, descriptive analyses were conducted with SPSS (Statistical Package for the Social Sciences) version 31.0 to summarise the characteristics of the participants, including demographics such as age, gender, and educational background, as well as other relevant study variables. Categorical variables were presented as counts and percentages, while continuous variables were reported as means and standard deviations. In addition, 95% confidence intervals (CIs) were calculated where appropriate to provide a measure of precision for the estimates. This approach ensured a clear and comprehensive overview of the study population.50% proportion was assumed in the sample size calculation as it provides the maximum variability and yields the most conservative (largest) sample size estimate in the absence of prior prevalence data. Ethical Approval Ethical approval was obtained from the Health Research Ethics Committee of North-WestUniversity for the larger and sub-studies, respectively (NWU-HREC, Ref. NWU-00090-24-A1; sub-study NWU-00090-24-A1-02) . The study was conducted after institutional support was received from the two district hospitals, which were selected based on the high influx of patients with the conditions under study as referral facilities in the district. The studywas funded by theNRFThuthuka Grant (Project No. TK23042095297) . All procedureswere conducted in accordance with theDeclaration of Helsinki . Written informed consent was obtained from all participants prior to data collection, and confidentiality was ensured by removing all identifiable information from the questionnaires before analysis. Results This cross-sectional descriptive study analysed demographic characteristics of 45 pregnant women living with both HIV/AIDS and GM in Chris Hani District, Eastern Cape Province. The sample represents a unique and vulnerable population requiring specialised healthcare management due to their dual diagnosis during pregnancy. Demographic Characteristics The study included 45 pregnant women diagnosed with both HIV/AIDS and DM in two hospitals in Chris Hani District, Eastern Cape Province. The mean age of participants was 33.8 years (SD ± 6.0), ranging from 17 to 48 years. The largest age group was 35–39 years (44.4%, n=20), followed by 30–34 years (28.9%, n=13), indicating that 73.3% of participants were aged 30 years or older. Advanced maternal age (≥35 years) was present in 55.5% of women, suggesting a substantial proportion at increased risk for pregnancy complications (p<0.001). Educational attainment was relatively high, with 51.1% (n=23) of participants completing secondary education and 28.9% (n=13) achieving tertiary-level education. Only 20% (n=9) had primary education. This indicates that approximately 80% of the sample had secondary education or higher, which may facilitate understanding of treatment regimens and self-management strategies for managing both HIV/AIDS and DM in pregnancy (p<0.05). Marital status distribution showed that 51.1% (n=23) of women were never married, 31.1% (n=14) were cohabitating, and the remaining participants were widowed (6.7%, n=3), separated (6.7%, n=3), or divorced (4.4%, n=2) (p<0.001). The high proportion of unmarried and cohabitating women may have implications for social support and healthcare decision-making during pregnancy. Regarding pregnancy status, most participants (60.0%, n=27) were in the third trimester, 24.4% (n=11) were in the puerperium, and 15.6% (n=7) were in the second trimester (p<0.05). This indicates that most women were identified or recruited later in pregnancy, which has implications for the timing of interventions and management strategies. Body mass index (BMI) assessment showed that nearly all participants were overweight (n=44), with only one underweight participant. All women (100%, n=45) reported receiving advice to lose weight. Statistical Notes: Chi-square tests were used for categorical variables. p < 0.001 indicates a highly significant deviation from expected equal distribution. Table 1 illustrates the comprehensive demographic characteristics of pregnant women living with DM and HIV/AIDS in pregnancy T able 1: COMPREHENSIVE DEMOGRAPHIC CHARACTERISTICS (n=45) SAMPLE SIZE PARTICIPANTS N:45 % P VALUE AGE p <0.001 <20 years 1 2.2 20-24 years 3 6.7 25-29 years 3 6.7 30-34 years 13 28.9 35-39 years 20 44.4 ≥40 years 5 11.1 EDUCATION LEVEL Primary 9 20.0 p <0.05 Secondary 23 51.1 Tertiary Level 13 28.9 MARITAL STATUS p <0.001 Never married 23 51.1 Cohabitating 14 31.1 Widowed 3 6.7 Separated 3 6.7 Divorced 2 4.4 PREGNANCY STATUS p <0.05 3rd trimester 27 60.0 Puerperium 11 24.4 2nd trimester 7 15.6 BMI Overweight 44 Underweight 1 ADVICE TO LOSE WEIGHT Yes 45 100 No 0 0 HIV Disease Characteristics Duration of HIV infection Participants had a mean HIV infection duration of 6.6 years (SD ± 4.0), ranging from 1 to 25 years. Most participants (91.1%) had been living with HIV for 10 years or less, with 46.7% (n=21) infected for 1–5 years and 44.4% (n=20) for 6–10 years. Only 8.9% (n=4) had been infected for more than 10 years. The distribution was statistically significant (p < 0.001), indicating that most of the study population had relatively recent HIV diagnoses, likely reflecting earlier detection and treatment programs. CD4 Count and immunological status Mean CD4 count was 398 cells/ml (SD ± 309), below the normal range (>500 cells/ml), indicating compromised immune function. The distribution of immunosuppression was as follows: 27.3% (n=12) had severe immunosuppression (<200 cells/ml), 34.1% (n=15) moderate (200–349 cells/ml), 13.6% (n=6) mild (350–499 cells/ml), and 25.0% (n=11) normal/minimal (≥500 cells/ml). Overall, 75% of participants had some degree of immunosuppression, with 61.4% experiencing moderate to severe immunosuppression, representing a high-risk population for opportunistic infections and pregnancy complications. The distribution was not statistically significant (p ≥ 0.05). Viral Load and Treatment Response Viral load analysis was limited due to missing data for 80% of participants (n=36). Among the nine participants with available data, 2 (4.4%) had undetectable viral loads (<50 copies/ml), 6 (13.3%) had low detectable levels (50–999 copies/ml), and 1 (2.2%) had moderate levels (1,000–9,999 copies/ml). No participants had high viral loads (≥10,000 copies/ml). The mean viral load among those with detectable values was 1,085 copies/ml (range 46–5,977). Due to the small number of available measurements, these findings are descriptive and not statistically significant (p ≥ 0.05). ART use and complications All participants (100%) were on antiretroviral therapy (ART). The most reported ART-related complication was diabetes (91%, n=41), followed by skin rash (7%, n=3) and vomiting (2%, n=1), with the distribution being statistically significant (p < 0.001). Table 2: illustrates the comprehensive HIV disease characteristics of pregnant women with DM and HIV/AIDS in pregnancy. Table 2: COMPREHENSIVE HIV DISEASE CHARACTERISTICS (n=45) HIV Disease Variable Category N=45 Percentage (%) p-value HIV INFECTION DURATION p 20 years 1 2.2 CD4 COUNT (cells/ml) p ≥0.05 <200 (Severe immunosuppression) 12 27.3 200-349 (Moderate immunosuppression) 15 34.1 350-499 (Mild immunosuppression) 6 13.6 ≥500 (Normal/minimal immunosuppression) 11 25.0 VIRAL LOAD p ≥0.05 Undetectable (<50 copies/ml) 2 4.4 Low detectable (50-999 copies/ml) 6 13.3 Moderate (1,000-9,999 copies/ml) 1 2.2 High (≥10,000 copies/ml) 0 0.0 Missing/Other 36 80.0 TAKEN ARV DRUGS Yes 45 100 -- No 0 0 ARV COMPLICATIONS Diabetes 41 91 p <0.001 Vomiting 1 2 Skin Rash 3 7 Characteristics of Diabetes mellitus in pregnancy Duration of DM in pregnancy Participants had a mean DM in pregnancy duration of 1.7 years (SD ± 1.4), ranging from 1 to 10 years. The majority (88.9%, n=40) had GDM for 1–2 years, 8.9% (n=4) for 3–5 years, and 2.2% (n=1) for more than 5 years; no participants had DM for less than 1 year. This distribution was statistically significant (p < 0.05), indicating that most women were recently diagnosed with DM in pregnancy, which may reflect effective screening or natural progression of diabetes in the context of HIV infection. Awareness and Health Literacy All participants (100%, n=45) were aware of their high blood sugar status, showing universal health literacy regarding DM in pregnancy (p < 0.01). This suggests effective healthcare communication, integrated diabetes education within antenatal care, and strong patient engagement. Current Blood sugar medication use All participants (100%, n=45) were currently taking blood sugar medications (p < 0.01), indicating complete treatment uptake among those diagnosed. Insulin use Only 6.7% (n=3) of participants required insulin therapy, while 93.3% (n=42) managed DM in pregnancy without insulin (p < 0.01). This pattern suggests that most cases were mild and managed effectively with oral medications or lifestyle interventions, reflecting appropriate clinical treatment stratification. Recent Adherence Medication use in the past two weeks showed that 71.1% (n=32) had adhered to treatment, while 28.9% (n=13) had not (p < 0.01). The gap between current treatment engagement (100%) and recent use (71%) indicate intermittent adherence and highlights the need for continued adherence support, despite high overall engagement. Blood pressure status Overall, 55% (n=25) of participants had normal blood pressure, 32% (n=14) had high BP, and 13% (n=6) had hypertension (p < 0.01). Table 3: illustrates the comprehensive GDM characteristics of pregnant women living with DM and HIV/AIDS in pregnancy Table 3: COMPREHENSIVE GDM CHARACTERISTICS (n=45) DM in pregnancy Variable Category N=45 Percentage (%) p-value DM IN PREGNANCY DURATION p <0.05 5 years 1 2.2 AWARENESS OF HIGH BLOOD SUGAR p <0.01 Yes 45 100.0 No 0 0.0 CURRENTLY TAKING BS DRUGS p <0.01 Yes 45 100.0 No 0 0.0 TAKING INSULIN p <0.01 Yes 3 6.7 No 42 93.3 BS DRUGS PAST 2 WEEKS p <0.01 Yes 32 71.1 No 13 28.9 OVERALL, BLOOD PRESSURE p <0.01 Normal 25 55 High BP 14 32 Hypertension 6 13 The study assessed dietary, physical activity, and transportation behaviours among 45 pregnant women with HIV/AIDS and DM. Fruit and vegetable intake was generally low, with most participants consuming only one day per week or one serving per day. Vegetable oil was the main cooking fat, and eating outside the home was relatively infrequent. Moderate physical activity and sports participation were high, while intensive activity and sports were limited. Walking was the predominant transportation mode, with limited use of private vehicles. These lifestyle patterns indicate suboptimal nutrition, adequate moderate activity, and reliance on walking/public transport, which can inform targeted interventions for this high-risk population. Table 4 illustrates the comprehensive lifestyle characteristics of pregnant women living with DM and HIV/AIDS in pregnancy Table 4: COMPREHENSIVE LIFESTYLE CHARACTERISTICS (n=45) Lifestyle Variable Category N=45 Percentage (%) p-value DIETARY PATTERNS Eating Fruit (days/week) p <0.05 One day 26 57.8 None 6 13.3 Two days 4 8.9 Three days 4 8.9 Four+ days 5 11.1 Fruit Servings per Day p <0.001 One serving 30 66.7 None 6 13.3 Two servings 4 8.9 Three servings 5 11.1 Eating Vegetables (days/week) p <0.05 One day 30 66.7 Two days 6 13.3 Three+ days 8 17.8 None 1 2.2 Vegetable Servings per Day p <0.001 One serving 32 71.1 Two servings 9 20.0 Three+ servings 4 8.9 Type of Oil Used p <0.05 Vegetable oil 30 66.7 All types 7 15.6 Margarine 5 11.1 Butter 2 4.4 Other 1 2.2 Eating Outside Home (days/week) p <0.05 Once 17 37.8 None 16 35.6 Twice 6 13.3 Three+ times 6 13.3 PHYSICAL ACTIVITY PATTERNS Intensive Activity p <0.001 Yes 8 17.8 No 37 82.2 Moderate Activity p <0.001 Yes 38 84.4 No 7 15.6 Intensive Sport p ≥0.05 Yes 18 40.0 No 27 60.0 Moderate Sport p <0.001 Yes 34 75.6 No 11 24.4 TRANSPORTATION PATTERNS Walking p <0.001 Yes 39 86.7 No 6 13.3 Taking Taxi p ≥0.05 Yes 28 62.2 No 17 37.8 Driving p <0.001 Yes 5 11.1 No 40 88.9 Discussion The term diabetes mellitus (DM) during pregnancy was used, as the duration reported reflects time since diagnosis and may extend beyond a single pregnancy period. A substantial proportion of participants were classified as being of advanced maternal age (≥37 years), which aligns with existing literature identifying increasing maternal age as a risk factor for DM in pregnancy and adverse obstetric outcomes [3,4]. Advanced maternal age is associated with reduced glucose tolerance during gestation, which heightens the risk of DM in pregnancy [5], and may exacerbate complications when combined with comorbid conditions such as obesity [9]. The concurrent presence of HIV/AIDS and DM in pregnancy in this demographic suggests a potentially high-risk profile in this setting, highlighting the need for tailored antenatal care strategies in the Chris Hani District, where multiple demographic and clinical risk factors intersect. Although 80% of participants had attained secondary or tertiary education, challenges such as poor nutritional intake and suboptimal treatment adherence persisted. These findings are consistent with reports indicating that women living with HIV/AIDS may face structural and systemic barriers despite higher educational attainment [18,19]. Immunologically, 61.4% of women exhibited moderate to severe immunosuppression (CD4 < 350 cells/mm³), indicating vulnerability to opportunistic infections and adverse perinatal outcomes. The substantial proportion of missing viral load data (80%) limited assessment of virologic suppression, reflecting incomplete monitoring in resource-limited settings [7]. These findings suggest that education alone may not be sufficient to overcome structural and systemic barriers, supporting the need for integrated interventions addressing nutrition, adherence support, and comprehensive HIV/AIDS and DM management. All participants were on ART, yet 91% reported diabetes as a treatment-related complication, consistent with previous studies showing that ART and pregnancy-related metabolic changes can increase the risk of insulin resistance and DM in pregnancy [8,9]. While awareness and engagement with DM in pregnancy treatment were high (100%), adherence to blood sugar medication was suboptimal, with only 71.1% reporting recent use. Similar patterns of high treatment initiation but inconsistent adherence have been documented, with psychosocial stressors, multiple medications, and pregnancy-related discomfort limiting sustained adherence [12,18]. These findings highlight the importance of integrated care pathways that combine HIV management with metabolic monitoring and adherence support to optimize maternal and infant outcomes in high-risk populations. Analysis of lifestyle habits revealed inadequate consumption of fruits and vegetables, low levels of intensive physical activity, and socioeconomic constraints, such as limited access to private transportation. Despite these limitations, moderate physical activity and walking were frequently reported, demonstrating resilience and mobility, similar to observations that women in resource-limited settings often adapt lifestyle behaviors within environmental constraints [10]. Overall, these results highlight the dual burden of infectious and non-communicable diseases among pregnant women living with HIV/AIDS and DM, emphasizing the need for integrated maternal health services that address nutrition, physical activity, medication adherence, and psychosocial wellbeing. These findings provide preliminary evidence to guide context-specific interventions and inform integrated HIV/AIDS and DM in pregnancy care models in high-burden regions. Limitations This study has several limitations that should be considered when interpreting the findings. Firstly, the small sample size of 45 participants restricts the generalisability of the results to larger populations or different contexts. Secondly, the cross-sectional design hinders the ability to make causal inferences and limits the assessment of temporal relationships between variables, such as the progression of HIV/AIDS and the onset of DM in pregnancy. Furthermore, viral load data were missing for 80% of participants, which significantly undermines the analysis of virologic suppression and its interaction with immunological and metabolic indicators. Lifestyle factors, including dietary intake, physical activity, and adherence, were self-reported, potentially introducing recall and social desirability biases. Additionally, the lack of a control group, such as pregnant women with either HIV/AIDS or DM, complicates efforts to isolate the specific effects of coexisting diagnoses. Lastly, biochemical markers for DM in pregnancy severity, such as fasting glucose and HbA1c, were not included, diminishing the ability to conduct clinical risk stratification. The study sought to address the characteristics of pregnant women living with both HIV/AIDS and DM in the Chris Hani District of the Eastern Cape Province. Its objective was to describe the demographic, clinical, and lifestyle characteristics of these women. The research successfully addressed this objective. Despite these limitations, this pilot study provides valuable preliminary insights into the demographic, clinical, and lifestyle characteristics of pregnant women living with both HIV/AIDS and DM in the Chris Hani District. The findings offer important baseline information that can inform the design of larger, more comprehensive studies and support the development of integrated maternal healthcare strategies in high-burden settings. The findings should be interpreted in the context that DM duration reflects ongoing disease rather than strictly DM limited to one pregnancy. Recommendations Antenatal nursing care should prioritise early screening and integrated management of HIV/AIDS and DM in pregnancy, starting before the third trimester. Nurses can enhance treatment adherence through personalised counselling, peer support, and mobile reminders, while also providing tailored health promotion that includes physical activity and nutritional counselling. It is crucial to address social determinants of health by facilitating access to resources for women with these dual diagnoses. Nursing curricula must include training on co-existing conditions, and further research should investigate the impact of integrated lifestyle interventions. Health policies should integrate non-communicable disease management into existing HIV/AIDS programs, standardise early antenatal screenings, and promote multi-sector collaboration to address transportation and social support needs for pregnant women. Continuous professional development for healthcare providers should also be mandated to ensure effective management of these health concerns. Conclusion In conclusion, this study highlights important associations between lifestyle factors, healthcare engagement, and immune and metabolic health outcomes among pregnant women living with both HIV/AIDS and DM. The findings indicate that blood pressure awareness, blood pressure medication use, moderate physical activity, and transportation access were associated with variations in CD4 counts and ARV therapy complications. Although some variables demonstrated non-significant trends, likely due to the small sample size and incomplete data, the results suggest the importance of integrated care, consistent monitoring, and lifestyle-focused interventions for this population. These findings may help inform training for healthcare providers by emphasizing the need for strengthened screening, patient education, and coordinated management of HIV/AIDS and DM in pregnancy during antenatal care. Future studies should focus on larger populations to further explore these relationships and evaluate the effectiveness of scaling up integrated interventions for women facing the dual challenges of HIV/AIDS and DM in similar high-burden settings. Abbreviations AIDS Acquired immunodeficiency virus ART Antiretroviral therapy ARV Antiretroviral BP Blood pressure CD4 Cluster of Differentiation 4 ECP Eastern Cape Province GDM Gestational Diabetes Mellitus HIV Human Immune Virus HREC Human Research Ethics Committee NWU North-West University SPSS Statistical Package for the Social Sciences PMTCT Prevention of Mother-to-Child Transmission Declarations Acknowledgements The authors express their gratitude to the Eastern Cape Department of Health, the staff at the participating hospitals in the selected district, and the research assistants for their invaluable support. We also wish to thank all the pregnant women who participated in the study, as well as acknowledge E.N. for their statistical guidance. Author contributions DT developed the concept and designed the study. EB and KM supervised the research process and critically revised the manuscript for intellectual content. All authors reviewed and approved the final version of the manuscript. Funding The study was funded by the NRF Thuthuka Project number (TK23042095297). Data availability The datasets generated and analysed during the study are not publicly available to protect participant confidentiality. However, de-identified data can be made available from the corresponding author upon reasonable request. Requests should be directed to Dineo Olefile Tsheole, School of Nursing Science, North-West University, Private Bag X2046, Mmabatho, 2745, South Africa. Email address: [email protected] Tel: +27 82 088 4630; ORCID identifier: https://orcid.org/00090-0005-1848-962 X . Ethical approval and consent to participate Ethical approval for this study was granted by the HREC at North-West University (NWU). This research was part of a larger study under ethics number NWU-00090-24-A1 and is funded by the NRF Thuthuka Project number (TK23042095297). The sub-study received additional approval from the NWU HREC (NWU-00090-24-A1-02). All procedureswere conducted in accordance with theDeclaration of Helsinki. Written informed consent was obtained from each participant before the interviews, as approved by the Ethical Committee. All identifiable data were removed from the questionnaire before analysis. Consent for publication Permission was obtained from the participants to publish the general results of the research. Competing interests The authors declare no competing interests. Conflict of interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Author details School of Nursing Sciences, NuMIQ Focus Area, North-West University, South Africa. References NWU Academic Guide. 2020. Potchefstroom: North-West University; 2020. p.27. 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Obstetrics: normal and problem pregnancies. 7th ed. Philadelphia: Elsevier; 2017. Silva A, Gomes M, Lima F, et al. Trends in HIV infection among women of reproductive age in Brazil: a ten-year review. Rev Soc Bras Med Trop. 2018;51(5):569–75. UNAIDS, Global. HIV & AIDS statistics fact sheet. Geneva: UNAIDS; 2022. Available at: https://www.unaids.org (Accessed 20 August 2025). Bhardwaj P. Types of sampling in research. J Pract Cardiovasc Sci. 2019;5(3):157–63. Wilkins E. HIV infection and AIDS. In: Watts RA, Conaghan PG, Denton C, Foster H, Isaacs J, Maddison P, editors. Oxford textbook of rheumatology. 4th ed. Oxford: Oxford University Press; 2020. pp. 41–50. Watson J, Brown A, Smith L. Immigration, stigma and HIV: a national review of psychosocial factors affecting women living with HIV. J Public Health. 2018;40(3):e245–53. Jasmine R, Thompson D, Patel M. Risk factors for gestational diabetes mellitus: a systematic review. J Womens Health. 2018;27(1):1–10. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviewers agreed at journal 11 May, 2026 Reviewers invited by journal 04 May, 2026 Editor invited by journal 08 Apr, 2026 Editor assigned by journal 06 Apr, 2026 Submission checks completed at journal 06 Apr, 2026 First submitted to journal 03 Apr, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9315119","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":637913387,"identity":"bd59015d-7d5f-47f6-88d3-5cd85e477037","order_by":0,"name":"Dineo Olefile Tsheole","email":"data:image/png;base64,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","orcid":"","institution":"North-West University","correspondingAuthor":true,"prefix":"","firstName":"Dineo","middleName":"Olefile","lastName":"Tsheole","suffix":""},{"id":637913388,"identity":"95cb24d9-71b4-41f4-94fc-cec3bd2eb233","order_by":1,"name":"Nokwanda Edith Bam","email":"","orcid":"","institution":"North-West University","correspondingAuthor":false,"prefix":"","firstName":"Nokwanda","middleName":"Edith","lastName":"Bam","suffix":""},{"id":637913389,"identity":"fe4282ed-c8f0-4f42-8a39-53105014c563","order_by":2,"name":"Kgomotso Mathope","email":"","orcid":"","institution":"North-West University","correspondingAuthor":false,"prefix":"","firstName":"Kgomotso","middleName":"","lastName":"Mathope","suffix":""}],"badges":[],"createdAt":"2026-04-03 17:08:42","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9315119/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9315119/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":109121632,"identity":"adb0f51b-a22e-42cb-b445-b837c8c438db","added_by":"auto","created_at":"2026-05-12 17:26:23","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":487471,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9315119/v1/507fd1fd-6fce-453a-8f3d-913bfa20b181.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Characteristics of pregnant women living with HIV/AIDS and gestational diabetes mellitus in the Chris Hani District, Eastern Cape Province","fulltext":[{"header":"What is already known about this topic?","content":"\u003cul\u003e\n \u003cli\u003ePregnant women living with HIV are at an elevated risk for adverse outcomes affecting both maternal and neonatal health. \u0026nbsp;\u003c/li\u003e\n \u003cli\u003e\u0026nbsp;The increasing prevalence of \u0026nbsp;GDM is a significant global concern, as it contributes to complications such as pre-eclampsia, preterm delivery, and neonatal health issues. \u0026nbsp;\u003c/li\u003e\n \u003cli\u003eWhile each of these conditions is well-documented independently, there is a lack of evidence regarding their combined impact in South African hospital settings, particularly in the Eastern Cape, where maternal health challenges remain high.\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e\u003cstrong\u003eWhat does this paper add to the currently published literature?\u003c/strong\u003e\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003eThis research offers new insights from two selected hospitals in the Chris Hani District of Eastern Cape Province, focusing on the demographic, clinical, and socio-behavioural characteristics of pregnant women living with both HIV/AIDS and GDM. It highlights the complex challenges these women face, including limited access to integrated antenatal care and the dual burden of both infectious and non-communicable diseases. The findings provide valuable, locally relevant evidence within the literature, especially in a rural South African context, where these conditions significantly influence maternal health outcomes.\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e\u003cstrong\u003eWhat is the most important implication for BMC Pregnancy and Childbirth?\u003c/strong\u003e\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003eThe research highlights the pressing need for early screening and integrated antenatal care in hospitals across the Eastern Cape to effectively address both HIV and GDM. \u0026nbsp;\u003c/li\u003e\n \u003cli\u003eIt provides relevant data that can inform policy development and maternal health programs aimed at minimising risks in pregnancies affected by both conditions. \u0026nbsp;\u003c/li\u003e\n \u003cli\u003eBy focusing on at-risk women in a resource-limited rural setting, this study contributes to the Journal’s mission to promote safer and more equitable childbirth worldwide.\u003c/li\u003e\n\u003c/ul\u003e"},{"header":"Introduction","content":"\u003cp\u003ePregnancy is a critical period during which maternal health conditions can affect both maternal and infant outcomes [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Two major challenges are diabetes mellitus (DM) and HIV/AIDS. Globally, DM affects around 14% of pregnancies, with the highest prevalence in low- and middle-income countries [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. DM during pregnancy is used to describe hyperglycaemia diagnosed during pregnancy or pre-existing diabetes identified during pregnancy[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. HIV/AIDS remains a significant public health issue, particularly in sub-Saharan Africa, where maternal prevalence is among the highest worldwide. In South Africa, an estimated 27% of pregnant women are HIV positive, most receiving lifelong antiretroviral therapy (ART) as part of Prevention of Mother-to-Child Transmission (PMTCT) [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eBoth HIV/AIDS and DM are associated with adverse maternal and infant outcomes. DM during pregnancy increases the risk of preeclampsia, caesarean section, macrosomia, and neonatal hypoglycaemia, and may predispose mothers and newborns to long-term metabolic conditions [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Maternal HIV/AIDS infection is linked to low birth weight, preterm delivery, increased infection risk, and psychosocial stressors [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Although both conditions may share biological mechanisms such as immune dysfunction and altered metabolism [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e], limited research has examined pregnant women who concurrently experience HIV/AIDS and DM, particularly in South Africa [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe Chris Hani District in the Eastern Cape Province was selected due to its high HIV/AIDS prevalence, emerging DM in pregnancy burden, and limited access to quality healthcare [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Understanding the demographic and clinical characteristics of pregnant women living with both conditions can inform integrated maternal healthcare strategies.\u003c/p\u003e \u003cp\u003eTherefore, this study aimed to describe the characteristics of pregnant women living with HIV/AIDS and GDM in Chris Hani, providing evidence to support targeted interventions, resource allocation, and maternal health policy in high-burden settings.\u003c/p\u003e \u003cp\u003eTherefore, this study aimed to describe the demographic and clinical characteristics of pregnant women living with HIV/AIDS and GDM in Chris Hani District, Eastern Cape. Specifically, the study sought to quantify these characteristics and examine associations between selected sociodemographic and clinical factors and the occurrence of GDM among women living with HIV/AIDS.\u003c/p\u003e"},{"header":"Methodology","content":"\u003cp\u003eThis study employed a quantitative, cross-sectional descriptive design within a pilot study framework. Data were collected using a structured WHO STEPwise questionnaire administered face-to-face. Participants with missing viral load data were excluded from analyses involving viral load, and the proportion of missing values was reported. Descriptive statistics and Chi-square tests were used to examine associations between participant characteristics and outcomes. No adjustments were made for multiple comparisons, as this was a pilot study and analyses were exploratory. A sample size of 45 participants was considered adequate to provide preliminary data on participant characteristics and feasibility, which will inform sample size calculations and study design for a subsequent larger study. The term diabetes mellitus (DM) during pregnancy was used, as the duration reported reflects time since diagnosis and may extend beyond a single pregnancy period. This study was conducted as a pilot study to assess feasibility, data collection processes, and preliminary associations. Therefore, a smaller sample size (n\u0026thinsp;=\u0026thinsp;45) was considered appropriate for exploratory analysis rather than hypothesis testing.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy site\u003c/h2\u003e \u003cp\u003eThis study was conducted in the Chris Hani District Municipality in the Eastern Cape Province (ECP) of South Africa. The ECP consists of two metropolitan municipalities, namely Buffalo City Metropolitan and Nelson Mandela Metropolitan Municipality, along with six districts: Amathole, Joe Ggapi, O.R. Tambo, Sarah Baartman, Chris Hani, and Alfred Nzo. The research primarily took place in two hospitals that serve a high number of pregnant women living with HIV/AIDS and DM. In Chris Hani, there are five primary healthcare clinics and two hospitals: Burgersdorp Clinic, Ngcobo Clinic, Rietvlei Clinic, Zingcuka Clinic, Wepener Clinic, Cofimvaba Hospital, and All Saints Hospital. These two Hospitals are the largest central hospitals in the area, offering a broader range of services and more resources than the primary healthcare clinics. Therefore, these hospitals were chosen for the pilot study due to their high volume of pregnant women living with HIV/AIDS and DM.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eStudy Population\u003c/h3\u003e\n\u003cp\u003eThe study population consisted of pregnant women residing in two selected hospitals during the survey period. A systematic random sampling method was employed to ensure a representative sample because it is simple, time- and cost-efficient, and ensures an evenly distributed sample [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. It reduces selection bias when the population list is random and is practical for a large population [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. The initial stage involved identifying the geographical area through a systematic and random approach to participant selection using sampling frames. For this pilot study, a total of 45 pregnant women living with both HIV/AIDS and DM were included to evaluate the study procedures. The sample size was determined using the single population proportion formula n = (Zα/2)2p(1-p)/d2, based on the following assumptions: a 95% confidence level (Z\u0026thinsp;=\u0026thinsp;1.96), an expected prevalence of 50% (p\u0026thinsp;=\u0026thinsp;0.5), and a margin of error of 15%(d\u0026thinsp;=\u0026thinsp;0.5). Based on these parameters, the required sample size was calculated to be 45 participants.\u003c/p\u003e\n\u003ch3\u003eMeasures\u003c/h3\u003e\n\u003cp\u003eData were collected using a structured questionnaire administered face-to-face in languages spoken locally, including English and isiXhosa, by the researcher and trained research assistants, with daily supervision and quality assurance checks provided by the research team lead. The questionnaires were developed and piloted to ensure that participants understood them. The tool was given to 3 participants to answer questions, and feedback was used to determine the need for modification. The questionnaire included three sections: demographic and behavioural measurements (age, education, ethnicity, marital status, pregnancy status, diet, physical activity, work, history of blood pressure, and history of diabetes), physical measurements (height, weight, waist circumference, blood pressure, and pulse), and biochemical measurements (blood glucose, blood lipids, CD4 count, viral load, and antiretroviral therapy regimen). All self-reported data were verified against clinical records where applicable, to ensure accuracy. These measures were used to assess the characteristics and health status of the study population and to refine study procedures before the main research.\u003c/p\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eData Analysis\u003c/h2\u003e \u003cp\u003eThe data collected from participants was first organised and reviewed using Microsoft Excel. Subsequently, descriptive analyses were conducted with SPSS (Statistical Package for the Social Sciences) version 31.0 to summarise the characteristics of the participants, including demographics such as age, gender, and educational background, as well as other relevant study variables. Categorical variables were presented as counts and percentages, while continuous variables were reported as means and standard deviations. In addition, 95% confidence intervals (CIs) were calculated where appropriate to provide a measure of precision for the estimates. This approach ensured a clear and comprehensive overview of the study population.50% proportion was assumed in the sample size calculation as it provides the maximum variability and yields the most conservative (largest) sample size estimate in the absence of prior prevalence data.\u003c/p\u003e \u003c/div\u003e\u003cp\u003e\u003cstrong\u003eEthical Approval\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical approval was obtained from the Health Research Ethics Committee of North-WestUniversity for the larger and sub-studies, respectively (NWU-HREC, Ref. NWU-00090-24-A1; sub-study NWU-00090-24-A1-02)\u003cstrong\u003e.\u003c/strong\u003e The study was conducted after institutional support was received from the two district hospitals, which were selected based on the high influx of patients with the conditions under study as referral facilities in the district. The studywas funded by theNRFThuthuka Grant (Project No. TK23042095297)\u003cstrong\u003e.\u0026nbsp;\u003c/strong\u003eAll procedureswere conducted in accordance with theDeclaration of Helsinki\u003cstrong\u003e.\u0026nbsp;\u003c/strong\u003eWritten informed consent was obtained from all participants prior to data collection, and confidentiality was ensured by removing all identifiable information from the questionnaires before analysis.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThis cross-sectional descriptive study analysed demographic characteristics of 45 pregnant women living with both HIV/AIDS and GM in Chris Hani District, Eastern Cape Province. The sample represents a unique and vulnerable population requiring specialised healthcare management due to their dual diagnosis during pregnancy.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDemographic Characteristics\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study included 45 pregnant women diagnosed with both HIV/AIDS and DM in two hospitals in Chris Hani District, Eastern Cape Province. The mean age of participants was 33.8 years (SD \u0026plusmn; 6.0), ranging from 17 to 48 years. The largest age group was 35\u0026ndash;39 years (44.4%, n=20), followed by 30\u0026ndash;34 years (28.9%, n=13), indicating that 73.3% of participants were aged 30 years or older. Advanced maternal age (\u0026ge;35 years) was present in 55.5% of women, suggesting a substantial proportion at increased risk for pregnancy complications (p\u0026lt;0.001).\u003c/p\u003e\n\u003cp\u003eEducational attainment was relatively high, with 51.1% (n=23) of participants completing secondary education and 28.9% (n=13) achieving tertiary-level education. Only 20% (n=9) had primary education. This indicates that approximately 80% of the sample had secondary education or higher, which may facilitate understanding of treatment regimens and self-management strategies for managing both HIV/AIDS and DM in pregnancy (p\u0026lt;0.05).\u003c/p\u003e\n\u003cp\u003eMarital status distribution showed that 51.1% (n=23) of women were never married, 31.1% (n=14) were cohabitating, and the remaining participants were widowed (6.7%, n=3), separated (6.7%, n=3), or divorced (4.4%, n=2) (p\u0026lt;0.001). The high proportion of unmarried and cohabitating women may have implications for social support and healthcare decision-making during pregnancy.\u003c/p\u003e\n\u003cp\u003eRegarding pregnancy status, most participants (60.0%, n=27) were in the third trimester, 24.4% (n=11) were in the puerperium, and 15.6% (n=7) were in the second trimester (p\u0026lt;0.05). This indicates that most women were identified or recruited later in pregnancy, which has implications for the timing of interventions and management strategies.\u003c/p\u003e\n\u003cp\u003eBody mass index (BMI) assessment showed that nearly all participants were overweight (n=44), with only one underweight participant. All women (100%, n=45) reported receiving advice to lose weight.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical Notes:\u003c/strong\u003e\u003c/p\u003e\n\u003cul type=\"disc\"\u003e\n \u003cli\u003eChi-square tests were used for categorical variables.\u003c/li\u003e\n \u003cli\u003ep \u0026lt; 0.001 indicates a highly significant deviation from expected equal distribution.\u0026nbsp;\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1\u003c/strong\u003e illustrates the comprehensive demographic characteristics of pregnant women living with DM and HIV/AIDS in pregnancy\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eT\u003c/strong\u003e\u003cstrong\u003eable 1: COMPREHENSIVE DEMOGRAPHIC CHARACTERISTICS\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e(n=45)\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"614\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSAMPLE SIZE\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePARTICIPANTS\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eN:45\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eP VALUE\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAGE\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep \u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;20 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e20-24 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e25-29 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e30-34 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e28.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e35-39 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e44.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026ge;40 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e11.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eEDUCATION LEVEL\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePrimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e20.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep \u0026lt;0.05\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSecondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e51.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTertiary Level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e28.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMARITAL STATUS\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep \u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNever married\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e51.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCohabitating\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e31.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eWidowed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSeparated\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eDivorced\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePREGNANCY STATUS\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep \u0026lt;0.05\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3rd trimester\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e60.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePuerperium\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e24.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2nd trimester\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e15.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eBMI\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eOverweight\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eUnderweight\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eADVICE TO LOSE WEIGHT\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp id=\"_Toc208332406\"\u003e\u003cstrong\u003eHIV Disease Characteristics\u003c/strong\u003e\u003cbr\u003e\u003cstrong\u003eDuration of HIV infection\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eParticipants had a mean HIV infection duration of 6.6 years (SD \u0026plusmn; 4.0), ranging from 1 to 25 years. Most participants (91.1%) had been living with HIV for 10 years or less, with 46.7% (n=21) infected for 1\u0026ndash;5 years and 44.4% (n=20) for 6\u0026ndash;10 years. Only 8.9% (n=4) had been infected for more than 10 years. The distribution was statistically significant (p \u0026lt; 0.001), indicating that most of the study population had relatively recent HIV diagnoses, likely reflecting earlier detection and treatment programs.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCD4 Count and immunological status\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMean CD4 count was 398 cells/ml (SD \u0026plusmn; 309), below the normal range (\u0026gt;500 cells/ml), indicating compromised immune function. The distribution of immunosuppression was as follows: 27.3% (n=12) had severe immunosuppression (\u0026lt;200 cells/ml), 34.1% (n=15) moderate (200\u0026ndash;349 cells/ml), 13.6% (n=6) mild (350\u0026ndash;499 cells/ml), and 25.0% (n=11) normal/minimal (\u0026ge;500 cells/ml). Overall, 75% of participants had some degree of immunosuppression, with 61.4% experiencing moderate to severe immunosuppression, representing a high-risk population for opportunistic infections and pregnancy complications. The distribution was not statistically significant (p \u0026ge; 0.05).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eViral Load and Treatment Response\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eViral load analysis was limited due to missing data for 80% of participants (n=36). Among the nine participants with available data, 2 (4.4%) had undetectable viral loads (\u0026lt;50 copies/ml), 6 (13.3%) had low detectable levels (50\u0026ndash;999 copies/ml), and 1 (2.2%) had moderate levels (1,000\u0026ndash;9,999 copies/ml). No participants had high viral loads (\u0026ge;10,000 copies/ml). The mean viral load among those with detectable values was 1,085 copies/ml (range 46\u0026ndash;5,977). Due to the small number of available measurements, these findings are descriptive and not statistically significant (p \u0026ge; 0.05).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eART use and complications\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll participants (100%) were on antiretroviral therapy (ART). The most reported ART-related complication was diabetes (91%, n=41), followed by skin rash (7%, n=3) and vomiting (2%, n=1), with the distribution being statistically significant (p \u0026lt; 0.001).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2:\u0026nbsp;\u003c/strong\u003eillustrates the comprehensive HIV disease characteristics of pregnant women with DM and HIV/AIDS in pregnancy.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2: COMPREHENSIVE HIV DISEASE CHARACTERISTICS\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;(n=45)\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"623\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eHIV Disease Variable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategory\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eN=45\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercentage (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eHIV INFECTION DURATION\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep \u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1-5 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e46.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6-10 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e44.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e11-15 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e16-20 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;20 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eCD4 COUNT (cells/ml)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep \u0026ge;0.05\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;200 (Severe immunosuppression)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e27.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e200-349 (Moderate immunosuppression)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e34.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e350-499 (Mild immunosuppression)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e13.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026ge;500 (Normal/minimal immunosuppression)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e25.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eVIRAL LOAD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep \u0026ge;0.05\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eUndetectable (\u0026lt;50 copies/ml)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eLow detectable (50-999 copies/ml)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e13.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eModerate (1,000-9,999 copies/ml)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eHigh (\u0026ge;10,000 copies/ml)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMissing/Other\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e80.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eTAKEN ARV DRUGS\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e--\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eARV COMPLICATIONS\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eDiabetes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep \u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eVomiting\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSkin Rash\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eCharacteristics of Diabetes mellitus in pregnancy\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDuration of DM in pregnancy\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eParticipants had a mean DM in pregnancy duration of 1.7 years (SD \u0026plusmn; 1.4), ranging from 1 to 10 years. The majority (88.9%, n=40) had GDM for 1\u0026ndash;2 years, 8.9% (n=4) for 3\u0026ndash;5 years, and 2.2% (n=1) for more than 5 years; no participants had DM for less than 1 year. This distribution was statistically significant (p \u0026lt; 0.05), indicating that most women were recently diagnosed with DM in pregnancy, which may reflect effective screening or natural progression of diabetes in the context of HIV infection.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAwareness and Health Literacy\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll participants (100%, n=45) were aware of their high blood sugar status, showing universal health literacy regarding DM in pregnancy (p \u0026lt; 0.01). This suggests effective healthcare communication, integrated diabetes education within antenatal care, and strong patient engagement.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCurrent Blood sugar medication use\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll participants (100%, n=45) were currently taking blood sugar medications (p \u0026lt; 0.01), indicating complete treatment uptake among those diagnosed.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInsulin use\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOnly 6.7% (n=3) of participants required insulin therapy, while 93.3% (n=42) managed DM in pregnancy without insulin (p \u0026lt; 0.01). This pattern suggests that most cases were mild and managed effectively with oral medications or lifestyle interventions, reflecting appropriate clinical treatment stratification.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRecent Adherence\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMedication use in the past two weeks showed that 71.1% (n=32) had adhered to treatment, while 28.9% (n=13) had not (p \u0026lt; 0.01). The gap between current treatment engagement (100%) and recent use (71%) indicate intermittent adherence and highlights the need for continued adherence support, despite high overall engagement.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eBlood pressure status\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOverall, 55% (n=25) of participants had normal blood pressure, 32% (n=14) had high BP, and\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;13% (n=6) had hypertension (p \u0026lt; 0.01).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3:\u003c/strong\u003e illustrates the comprehensive GDM characteristics of pregnant women living with DM and HIV/AIDS in pregnancy\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3: COMPREHENSIVE GDM CHARACTERISTICS \u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e(n=45)\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"633\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eDM \u0026nbsp;in pregnancy Variable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategory\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eN=45\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercentage (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eDM IN PREGNANCY DURATION\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep \u0026lt;0.05\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;1 year\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1-2 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e88.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3-5 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;5 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAWARENESS OF HIGH BLOOD SUGAR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep \u0026lt;0.01\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eCURRENTLY TAKING BS DRUGS\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep \u0026lt;0.01\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eTAKING INSULIN\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep \u0026lt;0.01\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e93.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eBS DRUGS PAST 2 WEEKS\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep \u0026lt;0.01\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e71.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e28.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eOVERALL, BLOOD PRESSURE\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep \u0026lt;0.01\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNormal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eHigh BP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eHypertension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eThe study assessed dietary, physical activity, and transportation behaviours among 45 pregnant women with HIV/AIDS and DM. Fruit and vegetable intake was generally low, with most participants consuming only one day per week or one serving per day. Vegetable oil was the main cooking fat, and eating outside the home was relatively infrequent. Moderate physical activity and sports participation were high, while intensive activity and sports were limited. Walking was the predominant transportation mode, with limited use of private vehicles. These lifestyle patterns indicate suboptimal nutrition, adequate moderate activity, and reliance on walking/public transport, which can inform targeted interventions for this high-risk population.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4\u003c/strong\u003e illustrates the comprehensive lifestyle characteristics of pregnant women living with DM and HIV/AIDS in pregnancy\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4: COMPREHENSIVE LIFESTYLE CHARACTERISTICS\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;(n=45)\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" class=\"fr-table-selection-hover\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eLifestyle Variable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategory\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eN=45\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercentage (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eDIETARY PATTERNS\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eEating Fruit (days/week)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep \u0026lt;0.05\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eOne day\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e57.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e13.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTwo days\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eThree days\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eFour+ days\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e11.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eFruit Servings per Day\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep \u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eOne serving\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e66.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e13.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTwo servings\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eThree servings\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e11.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eEating Vegetables (days/week)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep \u0026lt;0.05\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eOne day\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e66.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTwo days\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e13.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eThree+ days\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e17.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eVegetable Servings per Day\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep \u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eOne serving\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e71.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTwo servings\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e20.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eThree+ servings\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eType of Oil Used\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep \u0026lt;0.05\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eVegetable oil\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e66.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eAll types\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e15.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMargarine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e11.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eButter\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eEating Outside Home (days/week)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep \u0026lt;0.05\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eOnce\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e37.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e35.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTwice\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e13.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eThree+ times\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e13.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePHYSICAL ACTIVITY PATTERNS\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eIntensive Activity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep \u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e17.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e82.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eModerate Activity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep \u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e84.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e15.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eIntensive Sport\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep \u0026ge;0.05\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e40.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e60.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eModerate Sport\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep \u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e75.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e24.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eTRANSPORTATION PATTERNS\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eWalking\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep \u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e86.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e13.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eTaking Taxi\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep \u0026ge;0.05\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e62.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e37.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eDriving\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep \u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e11.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e88.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe term diabetes mellitus (DM) during pregnancy was used, as the duration reported reflects time since diagnosis and may extend beyond a single pregnancy period. A substantial proportion of participants were classified as being of advanced maternal age (≥37 years), which aligns with existing literature identifying increasing maternal age as a risk factor for DM in pregnancy and adverse obstetric outcomes\u0026nbsp;[3,4]. Advanced maternal age is associated with reduced glucose tolerance during gestation, which heightens the risk of DM in pregnancy [5], and may exacerbate complications when combined with comorbid conditions such as obesity [9]. The concurrent presence of HIV/AIDS and DM in pregnancy in this demographic suggests a potentially high-risk profile in this setting, highlighting the need for tailored antenatal care strategies in the Chris Hani District, where multiple demographic and clinical risk factors intersect.\u003c/p\u003e\n\u003cp\u003eAlthough 80% of participants had attained secondary or tertiary education, challenges such as poor nutritional intake and suboptimal treatment adherence persisted. These findings are consistent with reports indicating that women living with HIV/AIDS may face structural and systemic barriers despite higher educational attainment [18,19]. Immunologically, 61.4% of women exhibited moderate to severe immunosuppression (CD4 \u0026lt; 350 cells/mm³), indicating vulnerability to opportunistic infections and adverse perinatal outcomes. The substantial proportion of missing viral load data (80%) limited assessment of virologic suppression, reflecting incomplete monitoring in resource-limited settings\u0026nbsp;[7]. These findings suggest that education alone may not be sufficient to overcome structural and systemic barriers, supporting the need for integrated interventions addressing nutrition, adherence support, and comprehensive HIV/AIDS and DM management.\u003c/p\u003e\n\u003cp\u003eAll participants were on ART, yet 91% reported diabetes as a treatment-related complication, consistent with previous studies showing that ART and pregnancy-related metabolic changes can increase the risk of insulin resistance and DM in pregnancy [8,9]. While awareness and engagement with DM in pregnancy treatment were high (100%), adherence to blood sugar medication was suboptimal, with only 71.1% reporting recent use. Similar patterns of high treatment initiation but inconsistent adherence have been documented, with psychosocial stressors, multiple medications, and pregnancy-related discomfort limiting sustained adherence [12,18]. These findings highlight the importance of integrated care pathways that combine HIV management with metabolic monitoring and adherence support to optimize maternal and infant outcomes in high-risk populations.\u003c/p\u003e\n\u003cp\u003eAnalysis of lifestyle habits revealed inadequate consumption of fruits and vegetables, low levels of intensive physical activity, and socioeconomic constraints, such as limited access to private transportation. Despite these limitations, moderate physical activity and walking were frequently reported, demonstrating resilience and mobility, similar to observations that women in resource-limited settings often adapt lifestyle behaviors within environmental constraints [10]. Overall, these results highlight the dual burden of infectious and non-communicable diseases among pregnant women living with HIV/AIDS and DM, emphasizing the need for integrated maternal health services that address nutrition, physical activity, medication adherence, and psychosocial wellbeing. These findings provide preliminary evidence to guide context-specific interventions and inform integrated HIV/AIDS and DM in pregnancy care models in high-burden regions.\u003c/p\u003e\n\u003cp id=\"_Toc213154341\"\u003e\u003cstrong\u003eLimitations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study has several limitations that should be considered when interpreting the findings. Firstly, the small sample size of 45 participants restricts the generalisability of the results to larger populations or different contexts. Secondly, the cross-sectional design hinders the ability to make causal inferences and limits the assessment of temporal relationships between variables, such as the progression of \u0026nbsp;HIV/AIDS and the onset of \u0026nbsp;DM in pregnancy. Furthermore, viral load data were missing for 80% of participants, which significantly undermines the analysis of virologic suppression and its interaction with immunological and metabolic indicators. Lifestyle factors, including dietary intake, physical activity, and adherence, were self-reported, potentially introducing recall and social desirability biases. Additionally, the lack of a control group, such as pregnant women with either HIV/AIDS or DM, complicates efforts to isolate the specific effects of coexisting diagnoses. Lastly, biochemical markers for DM in pregnancy severity, such as fasting glucose and HbA1c, were not included, diminishing the ability to conduct clinical risk stratification. The study sought to address the characteristics of pregnant women living with both HIV/AIDS and DM in the Chris Hani District of the Eastern Cape Province. Its objective was to describe the demographic, clinical, and lifestyle characteristics of these women. The research successfully addressed this objective.\u003c/p\u003e\n\u003cp\u003eDespite these limitations, this pilot study provides valuable preliminary insights into the demographic, clinical, and lifestyle characteristics of pregnant women living with both HIV/AIDS and DM in the Chris Hani District. The findings offer important baseline information that can inform the design of larger, more comprehensive studies and support the development of integrated maternal healthcare strategies in high-burden settings. The findings should be interpreted in the context that DM duration reflects ongoing disease rather than strictly DM limited to one pregnancy.\u003c/p\u003e\n\u003cp id=\"_Toc213154342\"\u003e\u003cstrong\u003eRecommendations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAntenatal nursing care should prioritise early screening and integrated management of HIV/AIDS and DM in pregnancy, starting before the third trimester. Nurses can enhance treatment adherence through personalised counselling, peer support, and mobile reminders, while also providing tailored health promotion that includes physical activity and nutritional counselling. It is crucial to address social determinants of health by facilitating access to resources for women with these dual diagnoses. Nursing curricula must include training on co-existing conditions, and further research should investigate the impact of integrated lifestyle interventions. Health policies should integrate non-communicable disease management into existing HIV/AIDS programs, standardise early antenatal screenings, and promote multi-sector collaboration to address transportation and social support needs for pregnant women. Continuous professional development for healthcare providers should also be mandated to ensure effective management of these health concerns.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eIn conclusion, this study highlights important associations between lifestyle factors, healthcare engagement, and immune and metabolic health outcomes among pregnant women living with both HIV/AIDS and DM. The findings indicate that blood pressure awareness, blood pressure medication use, moderate physical activity, and transportation access were associated with variations in CD4 counts and ARV therapy complications. Although some variables demonstrated non-significant trends, likely due to the small sample size and incomplete data, the results suggest the importance of integrated care, consistent monitoring, and lifestyle-focused interventions for this population.\u003c/p\u003e\n\u003cp\u003eThese findings may help inform training for healthcare providers by emphasizing the need for strengthened screening, patient education, and coordinated management of HIV/AIDS and DM in pregnancy during antenatal care. Future studies should focus on larger populations to further explore these relationships and evaluate the effectiveness of scaling up integrated interventions for women facing the dual challenges of HIV/AIDS and DM in similar high-burden settings.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003cb\u003eAIDS\u003c/b\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAcquired immunodeficiency virus\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003cb\u003eART\u003c/b\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAntiretroviral therapy\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003cb\u003eARV\u003c/b\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAntiretroviral\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003cb\u003eBP\u003c/b\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eBlood pressure\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003cb\u003eCD4\u003c/b\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eCluster of Differentiation 4\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003cb\u003eECP\u003c/b\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eEastern Cape Province\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003cb\u003eGDM\u003c/b\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eGestational Diabetes Mellitus\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003cb\u003eHIV\u003c/b\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eHuman Immune Virus\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003cb\u003eHREC\u003c/b\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eHuman Research Ethics Committee\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003cb\u003eNWU\u003c/b\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eNorth-West University\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003cb\u003eSPSS\u003c/b\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eStatistical Package for the Social Sciences\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003cb\u003ePMTCT\u003c/b\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ePrevention of Mother-to-Child Transmission\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors express their gratitude to the Eastern Cape Department of Health, the staff at the participating hospitals in the selected district, and the research assistants for their invaluable support. We also wish to thank all the pregnant women who participated in the study, as well as acknowledge E.N. for their statistical guidance.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDT developed the concept and designed the study. EB and KM supervised the research process and critically revised the manuscript for intellectual content. All authors reviewed and approved the final version of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was funded by the NRF Thuthuka Project number (TK23042095297).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets generated and analysed during the study are not publicly available to protect participant confidentiality. However, de-identified data can be made available from the corresponding author upon reasonable request. Requests should be directed to Dineo Olefile Tsheole, School of Nursing Science, North-West University, Private Bag X2046, Mmabatho, 2745, South Africa. Email address: [email protected] Tel: +27 82 088 4630; ORCID identifier: https://orcid.org/00090-0005-1848-962\u003cu\u003eX\u003c/u\u003e.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical approval for this study was granted by the HREC at North-West University (NWU). This research was part of a larger study under ethics number NWU-00090-24-A1 and is funded by the NRF Thuthuka Project number (TK23042095297). The sub-study received additional approval from the NWU HREC (NWU-00090-24-A1-02). All procedureswere conducted in accordance with theDeclaration of Helsinki. Written informed consent was obtained from each participant before the interviews, as approved by the Ethical Committee.\u0026nbsp;All identifiable data were removed from the questionnaire before analysis.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePermission was obtained from the participants to publish the general results of the research.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor details\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSchool of Nursing Sciences, NuMIQ Focus Area, North-West University, South Africa.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eNWU Academic Guide. 2020. Potchefstroom: North-West University; 2020. p.27. Available at: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttp://www.nwu.ac.za/sites/www.nwu.ac.za/files/docs/Academic_Guide_2020.pdf\u003c/span\u003e\u003cspan address=\"http://www.nwu.ac.za/sites/www.nwu.ac.za/files/docs/Academic_Guide_2020.pdf\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e (Accessed 10 September 2025).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCunningham FG, Leveno KJ, Bloom SL, Spong CY, Dashe JS. Williams Obstetrics. 25th ed. New York: McGraw-Hill Education; 2021.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDirar A, Doupis J. Gestational diabetes from A to Z. World J Diabetes. 2017;8(12):489\u0026ndash;511.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePlows JF, Stanley JL, Baker PN, Reynolds CM, Vickers MH. The pathophysiology of gestational diabetes mellitus. Int J Mol Sci. 2018;19(11):3342\u0026ndash;57.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eUNAIDS, Global. HIV \u0026amp; AIDS statistics fact sheet. Geneva: UNAIDS; 2022. Available at: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.unaids.org\u003c/span\u003e\u003cspan address=\"https://www.unaids.org\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e (Accessed 20 August 2025).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWorld Health Organization. HIV fact sheet. Geneva: WHO. 2023. Available at: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.who.int/news-room/fact-sheets/detail/hiv-aids\u003c/span\u003e\u003cspan address=\"https://www.who.int/news-room/fact-sheets/detail/hiv-aids\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e (Accessed 04 August 2025).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWorku MG, Teshale AB, Tesema GA. Prevalence and associated factors of HIV testing among pregnant women: a multilevel analysis using demographic and health survey data from 11 East African countries. HIV AIDS (Auckl). 2021;13:181\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBarbour LA, McCurdy CE, Hernandez TL, Kirwan JP, Catalano PM, Friedman JE. Cellular mechanisms for insulin resistance in normal pregnancy and gestational diabetes. Diabetes Care. 2007;30(Suppl 2):S112\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCatalano PM, Shankar K. Obesity and pregnancy: mechanisms of short-term and long-term adverse consequences for mother and child. BMJ. 2017;356:j1\u0026ndash;10.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSimmons D, Jivan R, Ferrara A, et al. Long-term risk of type 2 diabetes following gestational diabetes mellitus: a systematic review. Diabetologia. 2023;66(11):2130\u0026ndash;40.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChilaka VN, Konje JC. Pathophysiology of human immunodeficiency virus (HIV) infection. Obstetrics, Gynaecology and Reproductive Medicine. 2021;31(12):484\u0026ndash;492.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJohnson M, Sabin C, Girardi E, et al. Psychosocial factors and mental health among women living with HIV: findings from the ASTRA study. HIV Med. 2018;19(Suppl 2):5\u0026ndash;12.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGabbe SG, Niebyl JR, Simpson JL, Landon MB, Galan HL, Jauniaux E, et al. Obstetrics: normal and problem pregnancies. 7th ed. Philadelphia: Elsevier; 2017.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSilva A, Gomes M, Lima F, et al. Trends in HIV infection among women of reproductive age in Brazil: a ten-year review. Rev Soc Bras Med Trop. 2018;51(5):569\u0026ndash;75.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eUNAIDS, Global. HIV \u0026amp; AIDS statistics fact sheet. Geneva: UNAIDS; 2022. Available at: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.unaids.org\u003c/span\u003e\u003cspan address=\"https://www.unaids.org\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e (Accessed 20 August 2025).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBhardwaj P. Types of sampling in research. J Pract Cardiovasc Sci. 2019;5(3):157\u0026ndash;63.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWilkins E. HIV infection and AIDS. In: Watts RA, Conaghan PG, Denton C, Foster H, Isaacs J, Maddison P, editors. Oxford textbook of rheumatology. 4th ed. Oxford: Oxford University Press; 2020. pp. 41\u0026ndash;50.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWatson J, Brown A, Smith L. Immigration, stigma and HIV: a national review of psychosocial factors affecting women living with HIV. J Public Health. 2018;40(3):e245\u0026ndash;53.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJasmine R, Thompson D, Patel M. Risk factors for gestational diabetes mellitus: a systematic review. J Womens Health. 2018;27(1):1\u0026ndash;10.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-pregnancy-and-childbirth","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"prch","sideBox":"Learn more about [BMC Pregnancy and Childbirth](http://bmcpregnancychildbirth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/prch/default.aspx","title":"BMC Pregnancy and Childbirth","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Diabetes mellitus, HIV/AIDS, Eastern Cape, pregnancy, pilot study, cross-sectional design","lastPublishedDoi":"10.21203/rs.3.rs-9315119/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9315119/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eThe coexistence of HIV/AIDS and Diabetes Mellitus (DM) during pregnancy creates unique challenges that elevate the risk of adverse outcomes for both mothers and newborns. Understanding the characteristics of women living with both conditions is crucial for developing targeted nursing interventions and enhancing antenatal care.\u003c/p\u003e\u003ch2\u003eObjective\u003c/h2\u003e \u003cp\u003eThis study aimed to describe the demographic, clinical, and lifestyle characteristics of pregnant women living with both HIV/AIDS and DM in the Chris Hani District, Eastern Cape Province (ECP).\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA quantitative research approach was employed, utilising a cross-sectional descriptive design within a pilot study framework. The pilot study was conducted to assess the feasibility of investigating the demographic, clinical, and lifestyle characteristics of pregnant women living with both HIV/AIDS and diabetes mellitus (DM) in the selected hospitals. The study was conducted in two hospitals in the Chris Hani District of the Eastern Cape Province and included 45 purposively selected pregnant women diagnosed with both HIV/AIDS and DM. The pilot design allowed for preliminary exploration of associations between participant characteristics and health outcomes, while also identifying potential challenges in data collection and measurement that could inform future larger-scale studies. Data were collected using a WHO STEPwise questionnaire and analysed using the Statistical Package for the Social Sciences (SPSS) version 31.0 to identify correlations between participant characteristics and the incidence of DM and HIV/AIDS.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe study examined factors affecting immune function in HIV/AIDS-positive women. It found that moderate sports participation, blood pressure awareness, and blood pressure medication use were linked to improved CD4 counts, indicating enhanced immune function. However, no significant associations were noted between lifestyle factors, transportation modes, or blood pressure status and antiretroviral (ARV) complications or viral load, likely due to limited sample sizes and missing data. Diabetes Mellitus (DM) emerged as the most common ARV complication across all groups. These findings highlight the importance of moderate physical activity and chronic disease management in supporting the immune health of women living with HIV/AIDS.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eWomen with HIV/AIDS in this study, particularly those aged 26 to 35, were more likely to have DM. The use of blood pressure medications and elevated viral loads was associated with increased metabolic risk. These findings suggest the potential value of early screening, consistent monitoring, and integrated care to address both HIV and DM, which may help improve outcomes for mothers and their infants.\u003c/p\u003e","manuscriptTitle":"Characteristics of pregnant women living with HIV/AIDS and gestational diabetes mellitus in the Chris Hani District, Eastern Cape Province","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-05-12 17:24:34","doi":"10.21203/rs.3.rs-9315119/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewerAgreed","content":"164994951045479563979611025184056573240","date":"2026-05-11T05:12:01+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-05-04T05:31:08+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-04-08T13:31:42+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-04-07T01:55:22+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-04-07T01:54:35+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Pregnancy and Childbirth","date":"2026-04-03T16:56:21+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-pregnancy-and-childbirth","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"prch","sideBox":"Learn more about [BMC Pregnancy and Childbirth](http://bmcpregnancychildbirth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/prch/default.aspx","title":"BMC Pregnancy and Childbirth","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"83c26e0e-5a2b-46a8-aeb8-a422363abad2","owner":[],"postedDate":"May 12th, 2026","published":true,"recentEditorialEvents":[{"type":"reviewerAgreed","content":"164994951045479563979611025184056573240","date":"2026-05-11T05:12:01+00:00","index":59,"fulltext":""},{"type":"reviewersInvited","content":"30","date":"2026-05-04T05:31:08+00:00","index":"","fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-05-12T17:24:34+00:00","versionOfRecord":[],"versionCreatedAt":"2026-05-12 17:24:34","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9315119","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9315119","identity":"rs-9315119","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}