Task-shifted Adaptation of the WHO-PEN Intervention to Address Cardio-metabolic Complications in People Living With HIV in Zambia

Objective 1 Focus group discussion participants/implementation survey participants: Inclusion: * 18 years of age or older * non-physician professional or lay/peer health care worker (HCW) involved with HIV and/or NCD service delivery. Key Informant Interview (KII) participants: * 18 years of age or older * a senior Ministry of Health (MOH) policy maker or health official working at national level in Zambia involved in managing, coordinating, and/or overseeing health services for non-communicable diseases in Zambia. In-depth interview participants: * emancipated HIV-infected adults 18 years of age or older have a documented cardio-metabolic condition Exclusion: * any potential IDI, FGD, or KII participant if they are unwilling or unable to provide informed consent. Objective 2: Cross-sectional assessments: Inclusion: * HIV-infected * aged 18 years and older * seeking care at either of the two ACHIEVE-supported pilot sites who are screened for and/or found to have evidence of one or more of the cardio-metabolic conditions or risk factors. Nested cohort participants: Inclusion: * documented HIV infection * aged 18 years or older * have one or more cardio-metabolic conditions or risk factors: * obesity (defined as BMI \> 30 kg/m\^2); * any current tobacco smoking; * hypertension as defined by WHO PEN (i.e., systolic blood pressure (SBP) = 140 mmHg and/or diastolic blood pressure (DBP) = 90 mmHg); * diabetes mellitus as defined by WHO PEN (i.e. random plasma glucose = 11.1 mmol/L, fasting plasma glucose = 7 mmol/L, and/or haemoglobin A1c = 48 mmol/mol); * prediabetes (defined as having impaired fasting glucose of 6.1 to 6.9 mmol/L, impaired glucose tolerance with a two-hour, post-oral glucose tolerance test glucose =7.8 mmol/L but \<11.1 mmol/L and a fasting plasma glucose \<7.0 mmol/L, and/or haemoglobin A1c 42 to 48 mmol/mol); 6) dyslipidaemia (defined as total cholesterol \>4 mmol/L or low density lipoprotein =6 mmol/L); and/or 7) personal history or medication use for heart disease, heart failure, stroke, or other cardio-metabolic complication (including but not limited to coronary artery disease, cerebrovascular disease, myocardial infarction, stroke, or peripheral vascular disease). IDI participants: * HIV-infected * 18 years of age who were enrolled in the nested cohort and had documented exposure to the TASKPEN intervention at a pilot site. FGD participants: * 18 years of age or older * a non physician health care worker (NPHW) or community health worker (CHW)/ lay health provider involved with TASKPEN or integrated HIV/NCD service delivery generally familiar with HIV and/or NCD service delivery at their facility. KII participants: * 18 years of age or older * a facility-level antiretroviral therapy (ART) or out-patient department (OPD) clinic manager/ in-charge or policy maker at district, provincial, or national level in Zambia; and generally familiar with HIV and/or NCD-related issues in their community. Exclusion criteria: For the nested cohort component, investigators will exclude: * adults who have no documented evidence of having established HIV care at the sites. * people unlikely to remain at the site to the completion of the study follow-up. * any potential IDI, FGD, or KII participant if they are unwilling or unable to provide written informed consent.