Hypertension Care for People With HIV in Tanzania: Provider Perspectives and Opportunities for Improvement

J Int Assoc Provid AIDS Care. 2021 Jan-Dec:20:23259582211052399. doi: 10.1177/23259582211052399.

Abstract

One in three people with HIV (PWH) has hypertension. However, most hypertensive PWH in sub-Saharan Africa are unaware of their hypertension diagnosis and are not on treatment. To better understand barriers to hypertension care faced by PWH, we interviewed 15 medical providers who care for patients with HIV and hypertension in northern Tanzania. The data revealed barriers at the patient, provider, and system level and included: stress, depression, and HIV-related stigma; lack of hypertension knowledge; insufficient hypertension training; inefficient prescribing practices; challenges with counselling; capacity limitations in hypertension care; high costs of care; and lack of routine hypertension screening and follow-up. Opportunities for improvement focused on prioritizing resources and funding towards hypertension care. System-related challenges were the underlying cause of barriers at individual levels. Strategies that focus on strengthening capacity and utilize existing HIV platforms to promote hypertension care delivery are urgently needed to improve cardiovascular outcomes among PWH.

Keywords: HIV; Tanzania; healthcare providers; hypertension; sub-Saharan Africa.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Counseling
  • HIV Infections* / complications
  • HIV Infections* / drug therapy
  • HIV Infections* / epidemiology
  • Humans
  • Hypertension* / epidemiology
  • Hypertension* / therapy
  • Social Stigma
  • Tanzania / epidemiology