ArticleResearch square2026
Models for Integrated HIV-Hypertension Care: Comparative Analysis of Six Integration Approaches from Implementation Research Projects Across Africa.
Article in Research square, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 7 registered trials, which are not on this map. Not yet cited in PubMed.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Scaling Out and Scaling Up the Systems Analysis and Improvement Approach to Optimize the Hypertension Diagnosis and Care Cascade for HIV-infected Individuals
Mixed Methods Formative Research and Pilot Testing of a Task-shifted Adaptation of the WHO-PEN Intervention to Address Cardio-metabolic Complications in People Living With HIV in Zambia
Managing Hypertension Among People Living With HIV: An Integrated Model (MAP-IT)
Integrating Hypertension and Cardiovascular Diseases Care Into Existing HIV Services Package in Botswana (InterCARE)
PULESA Uganda: Strengthening the Blood Pressure Care and Treatment Cascade for Ugandans Living With HIV-ImpLEmentation Strategies to SAve Lives
The Integrating HIV and hEART Health in South Africa Intervention Study
Z 32201 - Effects of a Package of Evidence-based Interventions and Implementation Strategies Based on WHO PEN for People Living With HIV and Cardio-metabolic Conditions in Lusaka, Zambia: A Type II Hybrid Effectiveness-implementation Stepped Wedge Trial
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14 authors.
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Abstract
Introduction: In 2020, the National Heart, Lung and Blood Institute formed the Heart, Lung, and Blood Co-morbiditieS IMplementation Models in People Living with HIV (HLB SIMPLe) Alliance, funding implementation research projects in six countries in Africa including Botswana, Mozambique, Nigeria, South Africa, Uganda and Zambia to test diverse models for integrating hypertension services into routine HIV care. We describe key similarities and differences amongst the integration models. Methods: This sequential explanatory mixed-methods study used online structured questionnaires and meetings to gather quantitative and qualitative data from each project. Integration was defined as the delivery of HIV and hypertension care concurrently for people living with HIV, specifically across the WHO health system building blocks: service delivery (care delivered at the same time/same location), health workforce (same team of healthcare providers), health information systems (merging of information systems), access to essential medicines (medications for both HIV and hypertension in the same pharmacy), and health financing (integrated funding). Data were analyzed using descriptive statistics and rapid deductive content analysis. We then used this data together with the WHO Health System Building Blocks framework to describe HIV-hypertension integration models across key aspects of the health system. Results: All models fully integrated service delivery and health workforce, often using task sharing to address workforce shortages. Full integration of health information systems was observed in 5/6 projects, and integrated access to essential medication in all projects. Integration occurred at the primary healthcare level and excluded complicated hypertension cases. Only 2/6 projects had integrated health financing for HIV/hypertension care. Conclusions: This examination highlights high convergence in the design of HIV and hypertension care integration models across WHO Health System Building Blocks despite different study settings, with the main difference being divergent mechanisms of health financing for integrated HIV/hypertension care. Lessons learned will help develop a core set of guidelines for building country-specific models for integrating hypertension and HIV care across different African settings. Trial Registration: NCT05414526 / NCT05002322 / NCT05031819 / NCT05846503 / NCT05609513 / NCT05005130 / NCT05950919. Clinical Trial Numbers: NCT05414526 (1/31/2023-8/31/2025) (Botswana), NCT05002322 (2/13/2023-12/31/2025) (Mozambique), NCT05031819 (10/26/2022-4/30/2025) (Nigeria), NCT05846503 (6/1/2023-5/31/2025) (South Africa), NCT05609513 (02/06/2023-10/3/2025) (Uganda), NCT05005130 (9/20/2021-12/23/2022); NCT05950919 (05/30/2023-12/01/2025) (Zambia).
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.