Data from: Low levels of hypertension screening in HIV care clinics in rural Uganda: a mixed methods study

Background: The prevalence of hypertension (HTN) among people living with
HIV (PLHIV) has increased over the last decade globally. Given the dual
burden of disease and significant prior investment in HIV care,
integrating care for HTN and HIV is recommended. However, data on HTN
screening, treatment, and control prior to such integration are
lacking.  Using a mixed-methods approach, we assessed the
baseline status of HTN screening, treatment, and control in 52 Ugandan
public health facilities, participating in an ongoing cluster randomised
trial of an integrated HIV/HTN care model. Methods: From November 2020 to
March 2021, we reviewed patient records and randomly sampled 50 PLHIV
without a documented HTN diagnosis per health facility and all PLHIV with
a documented HTN diagnosis per health facility. We surveyed the sampled
participants, took their blood pressure measurements, and described the
HTN care cascade. We also conducted in-depth interviews with 24 patients
and 12 providers to explore their experience with HTN screening and care.
We used an in-depth thematic approach to analyze the resulting qualitative
data. Results:  Among 2,645 PLHIV, <1% (20/2,645) reported
having their BP measured within 6 months before the survey. The prevalence
of HTN was 13.6% (359/2,645), including 287 (10.5%) newly diagnoses and 32
(1.2%) prior diagnoses that were not documented in their health record. Of
49 (1.9%) with a previously documented HTN diagnosis, 31 (63%) were on HTN
treatment, and 53% had controlled HTN. In-depth interviews with providers
and patients revealed a lack of blood pressure equipment, high patient
load, limited technical HTN knowledge, and patients' fear of
anticipated long waiting times as reasons for low HTN screening in the HIV
clinics.  Conclusion: Regular screening for the detection of HTN
patients was hardly performed. There is an urgent need for interventions
to advance the integration of HTN care in HIV clinics.