Factors affecting menstrual hygiene among women living in slum areas of Budanilakantha Municipality, Kathmandu.

The growing burden of non-communicable diseases (NCDs) among people living with Human Immunodeficiency Virus (PWH) is threatening gains in life expectancy achieved through increased access to antiretroviral therapy []. It is estimated that 20% of PWH have been diagnosed with at least one NCD, with low- and middle-income countries (LMICs) disproportionally impacted by these trends [,]. To address this challenge, the WHO has called for integrating the prevention and management of major NCDs in the context of HIV care to improve HIV treatment outcomes [,]. Evidence from high-income countries and LMICs shows that integrating HIV care with screening and/or treatment for NCDs and substance use disorders improves overall health outcomes for PWH, enhances health system efficiency and reduces healthcare costs [–]. The WHO, UN, UNAIDS, and the US President’s Emergency Plan for AIDS Relief (PEPFAR) all emphasize the importance of routine NCD screening, diagnosis, and treatment for PWH [,–]. Moreover, PEPFAR has funded collaborative research initiatives such as the NCD/HIV Integrated Care Project (2014–2021) to advance this agenda []. NCD-HIV integration in LMICs is enabled by a range of factors that are outlined in the WHO’s six Building Blocks for health systems strengthening and are also endorsed by PEPFAR [,]. These factors include a trained workforce, health information systems, reliable medication supply chains, financing, and leaders who prioritize integration [,–]. The WHO building blocks further serve as indicators to evaluate system robustness and to analyze whether the conditions necessary for integrated NCD-HIV care are currently being met in LMICs [].