Integrated Hypertension and HIV Care Cascades in Uganda

Study Overview
=================
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.

Official Title
-----------------
Integrated Hypertension and HIV Care Cascades in a HIV Treatment Program in Eastern Uganda: a Retrospective Cohort Study

Conditions
-----------------
Hypertension, HIV

Intervention / Treatment
-----------------
* Other: Blood pressure management in the HIV program


Participation Criteria
=================
Eligibility Criteria
-----------------
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.

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Overall cohort<br>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. | Other: Blood pressure management in the HIV program<br>* Integrated care for hypertension and HIV in the HIV program<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | 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 | 

Secondary Outcome Measures

| Outcome Measure | 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 | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Integrated, Care cascade, Uganda