BackgroundNon-communicable diseases (NCDs) are increasing in Kenya, where HIV/AIDS remains a leading cause of death; however, few studies have investigated obesity and hypertension among adults with HIV infection. We conducted a cross-sectional study in Homa Bay, Western Kenya, during 2015 to determine the prevalence of overweight/obesity and hypertension among HIV-infected adults and to identify their risk factors.ResultsAnthropometric measurements and a structured questionnaire were administered to adults with HIV infection receiving care at Mbita Sub-county Hospital. A total of 251 HIV-positive individuals were enrolled. More women were overweight (17.2%) and obese (3.6%) than underweight (8.3%). The prevalence of abdominal obesity was high in women (62.7%), especially those aged 30–39 years. The prevalence of hypertension was 9.8% and 11.8% in men and women, respectively. Male participants tended to develop hypertension at an early age. Multivariate analysis showed that female sex was significantly associated with abdominal obesity. Regarding clinical factors, we identified an association between overweight and a history of opportunistic infections, as well as between hypertension and World Health Organization clinical stage. Sixty percent of HIV-infected participants assumed that a very thin body size indicated HIV infection.ConclusionsThe main findings of this study include a greater prevalence of overweight than underweight as well as a high prevalence of abdominal obesity among women. Social perception toward body size among people with HIV infection might remain problematic. Individuals living with HIV in Kenya should receive preventive intervention for overweight and abdominal obesity, with consideration of relevant social and cultural aspects.