Prevalence and associated factors of overweight/obesity and central obesity among adults receiving dolutegravir-based first-line treatment in health facilities at hawassa city administration, sidama region.

Background: Overweight and obesity are emerging public health challenges globally, increasingly affecting people living with human immunodeficiency virus (HIV). This study assessed the prevalence and factors associated with overweight/obesity and central obesity among adults receiving dolutegravir (DTG)-based first-line antiretroviral therapy (ART) in Hawassa City Administration, Sidama region. Methods: This facility-based cross-sectional study was conducted between January 2023 and May 2024 among 439 adults with HIV, selected using systematic sampling. Data were collected using a pretested questionnaire. Anthropometric measurements (weight, height, and waist circumference) were obtained following World Health Organization protocols. Binary logistic regression was used to identify factors associated with overweight/obesity and central obesity. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were used to measure the strength of associations, and statistical significance was set at Results: Among the 433 participants (98.6% response rate), 58.7% were women and the mean age was 40.8 ± 9.6 years. The combined prevalence of overweight/obesity was 45.0% (95% CI: 40.6-49.9), with 31.4% overweight and 13.6% obesity. Central obesity was present in 49.7% (95% CI: 45.3-54.5). Being female (aOR = 1.9; 95% CI: 1.3-3.0), physical inactivity (aOR = 2.9; 95% CI: 1.9-4.6), self-reported recall problem (aOR = 1.6; 95% CI: 1.05-2.4), vegetables consumption on ≥5 days/week (aOR = 0.55; 95% CI: 0.32-0.95) and age >40 years (aOR = 1.8; 95% CI: 1.2-2.7) were significantly associated with overweight/obesity. Being female (aOR = 4.9; 95% CI: 2.9-8.3), age >40 years (aOR = 2.7; 95% CI: 1.7-4.3), physical inactivity (aOR = 2.8; 95% CI: 1.7-4.5), self-reported recall problem (aOR = 1.7; 95% CI: 1.04-2.7) and tuberculosis infection (aOR = 0.48; 95%CI: 0.27-0.84) were significantly associated with central obesity. However, switching to DTG, ART duration and duration on DTG were not significantly associated with overweight/obesity or central obesity. Conclusion: This study found a substantial burden of overweight/obesity and central obesity among adults receiving DTG-based first-line ART. These findings highlight the importance of incorporating routine anthropometric assessment, nutritional counseling, physical activity promotion, and weight-management support into comprehensive HIV care to mitigate this burden.