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In this retrospective cohort study, we mapped the care cascades for both Hypertension and HIV within a HIV program in Uganda with the goal of identifying opportunities for developing contextually appropriate integrated care models, .
Persons living with HIV (PLHIV) and receiving anti-retroviral therapy (ART) are at increased risk of cardiovascular disease (CVD) due to direct effects of ART and HIV infection itself, compounded by traditional CVD risk factors such as increased life expectancy and Westernized diet. Additionally, in sub-Saharan Africa, as is the case globally, hypertension (HTN) is a major risk factor for CVD. The prevalence of HTN in the setting of HIV reported in the literature is variable but may be higher than in the HIV-negative population.
World Health Organization (WHO) and Ugandan national HIV guidelines have recommended the integration of hypertension care into HIV programs since 2014 and 2016, but there has been limited uptake of this recommendation in practice. There have been successful efforts to integrate tuberculosis, malaria, nutrition, maternal-child health, and family planning into HIV programmes in Uganda. In this study, with the goal of identifying opportunities for developing contextually appropriate integrated care models, we mapped the care cascades for both HTN and HIV within a HIV program in Uganda.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Overall cohort | All Persons Living with HIV who enlisted in any one of three high-volume HIV clinics in Tororo District of Eastern Uganda between 2014 and 2017. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Blood pressure management in the HIV program | Other | Integrated care for hypertension and HIV in the HIV program |
|
| Measure | Description | Time Frame |
|---|---|---|
| Blood pressure control | Blood pressure control among Persons living with both HIV and hypertension. Achieving Blood pressure of <140/90mmHg | 1 year |
| Measure | Description | Time Frame |
|---|---|---|
| HIV control | HIV control among persons living with both HIV and hypertension. Defined as HIV Viral suppression. Viral load of <1000 copies/mL | 1 year |
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Inclusion Criteria:
Exclusion Criteria:
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Persons Living with HIV (PLHIV) 18 years of age and above who were already diagnosed with HIV and enrolled into HIV care at any of the three sites between January 2014 and January 2017.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Makerere University College of Health Sciences | Kampala | Central Region | +256 | Uganda |
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6 months
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| ID | Term |
|---|---|
| D006973 | Hypertension |
| ID | Term |
|---|---|
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
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