Conference Abstract | Volume 8, Abstract NACNDC/19JASH039 (Poster ) | Published: 06 Dec 2025
Isaac Kimera1,2,&, Isaac Ssinabulya1,3,4, Christabellah Namugenyi5, Florence Ayebare6, Douglas Musimbaggo1, Priscilla Apolot1, Isa Ssemakula1, Caroline Kirabo Namugga7, Mary Nakiganda1, John Kiggundu6, Martin Muddu6, Joanita Nangendo1, George Patrick Akabwai1, Edrisa Ibrahim Mutebi1, Fred Semitala1,2
1Makerere University College of Health Sciences, Kampala, Uganda, 2Makerere University Joint AIDS Program, Kampala, Uganda, 3Uganda Initiative for Integrated Management of Non-Communicable Diseases, Kampala, Uganda, 4Uganda Heart Institute, Kampala, Uganda, 5Makerere University School of Statistics and Planning, Kampala, Uganda, 6Infectious Diseases Research Collaboration, Kampala, Uganda, 7Our Lady of Consolata Kisubi Hospital, Entebbe, Uganda
&Corresponding author: Isaac Kimera, Makerere University Joint AIDS Program Old Mulago Hospital Staff Road, P.O. Box 7587, Kampala, Uganda, Email: 74kimera@gmail.com
Received: 11 Sep 2025, Accepted: 20 Oct 2025, Published: 06 Dec 2025
Domain: Infectious Disease Epidemiology
Keywords: HIV, hypertension, multi-month dispensing, adherence, compliance
©Isaac Kimera et al. Journal of Interventional Epidemiology and Public Health (ISSN: 2664-2824). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Cite this article: Isaac Kimera et al., Patient and provider factors affecting blood pressure control within integrated HIV care at a peri-urban clinic in Uganda: A mixed methods study. Journal of Interventional Epidemiology and Public Health. 2025;8(ConfProc6):039. https://doi.org/10.37432/JIEPH-CONFPRO6-00039
Hypertension, highly prevalent among persons living with HIV(PLHIV), is a key risk factor for cardiovascular disease. Even with integrated care, hypertension control remains suboptimal. Current guidelines recommend initial monthly titration of hypertension(HTN) medicines until blood pressure(BP) control is achieved before extending refill intervals through multi-month dispensing(MMD). We explored patient and provider factors affecting hypertension control among PLHIV receiving integrated MMD of HIV and hypertension medicines at Kisubi Hospital.
Of the 196 participants enrolled, 121(62%) were female. HIV suppression was maintained at 99%. Adherence to hypertension medication was 80%. Mean BP decreased from 152/95 mmHg (±24/15) to 139/85 mmHg (±17/11). Most patients (164;84%), received MMD before initial BP control. The proportion of participants with controlled BP increased from 10% at the initiation of integrated care to 50% over a median follow-up of 23 months. From the adjusted Generalized Estimating Equation model, the population-averaged probability of BP control across visits was 40% (95%CI:37,41%) while the adjusted probability of receiving a treatment protocol-compliant prescription was 47% (95%CI:41,53%). Patients with compliant prescriptions achieved BP control faster than those without (median time of 4 vs 11 months, p<0.001). Key barriers to patient adherence included forgetting, lack of symptoms, and discontinuing treatment once BP normalized. Provider non-compliance was driven by perceived patient non-adherence, knowledge gaps, costs associated with monthly visits before BP control, and patient requests for extended refills despite uncontrolled BP.
Optimizing hypertension outcomes in integrated HIV care requires strengthening both patient adherence support and provider compliance with treatment guidelines. MMD paired with timely medication titration may offer a promising strategy for patients with uncontrolled BP where frequent clinic visits are not feasible. Future research to explore strategies to improve patient adherence and provider compliance.
Menu