Integrated Hypertension and HIV Care Cascades in Uganda

Completed

• Conditions: HIV; Hypertension
• Interventions: Other: Blood pressure management in the HIV program

• Registration Number: NCT03605043
• Lead Sponsor: Makerere University

Brief Summary

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, .

Detailed Description

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.

Study Timeline

• Study Start: 2014-01-01
• Primary Completion: 2017-12-31
• Study Completion: 2018-05-30
• Status Verified: 2018-07
• Study First Submitted: 2018-07-21
• Study First Submitted QC: 2018-07-21
• Last Update Submitted: 2018-07-21
• Study First Posted: 2018-07-30
• Last Update Posted: 2018-07-30

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 1649

Inclusion Criteria

• 18 years of age and above, Having started Antiretroviral therapy between January 2014 and January 2017.

Exclusion Criteria

• PLHIV receiving treatment from clinics other than the 3 selected sites.

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Overall cohort	Blood pressure management in the HIV program	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.

Primary Outcome Measures

Name	Time	Method
Blood pressure control	1 year	Blood pressure control among Persons living with both HIV and hypertension. Achieving Blood pressure of \<140/90mmHg

Secondary Outcome Measures

Name	Time	Method
HIV control	1 year	HIV control among persons living with both HIV and hypertension. Defined as HIV Viral suppression. Viral load of \<1000 copies/mL

Trial Locations

Locations (1)

Makerere University College of Health Sciences; 🇺🇬 Kampala, Central, Uganda