Integrated Hypertension and HIV Care Cascades in Uganda

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.