Uptake of community blood pressure monitoring and associated factors among people living with HIV and hypertension accessing care at selected HIV clinics in urban and peri-urban Uganda

Abstract

INTRODUCTION: The World Health Organization recommends Community-based blood pressure monitoring (BPM) for diagnosis and management of hypertension. However, there is limited data on the uptake and factors associated with community BPM among people living with HIV (PLHIV) and hypertension in many low-income settings including Uganda. This study aimed to determine the uptake of, and factors associated with community BPM among PLHIV and hypertension receiving care at selected HIV clinics. METHODS: A cross-sectional study was conducted between May and July 2024 at three HIV clinics participating in an implementation trial [(NCT05609513), registration date, November 8, 2022) in the Kampala and Wakiso districts. Participants were proportionally distributed across the clinics, were randomly selected and surveyed using a pretested questionnaire. Descriptive statistics were performed, reporting means or medians with standard deviations (SD)/interquartile ranges (IQR) and frequencies with proportions for numerical and categorical variables, respectively. Factors associated with community BPM uptake were assessed using bi-variable and multivariable modified Poisson regression. Data analysis was performed using STATA 14.1. RESULTS: Of the 408 participants, 67.7% were female, mean age of 50.1 years (SD = 10.7). Community BPM uptake was 27%. Among those monitoring their BP in the community, 68.6% did so at private clinics, 70% at pharmacies, 15.2% at public health facilities, and 5.4% self-monitored their BP. Multivariable analysis indicated that the uptake of community BPM was associated with receiving three antihypertensive medications, receiving advice from healthcare providers, receiving feedback on BP monitoring and owning a BP device. CONCLUSION: Community BPM uptake among PLHIV and hypertension was low. However, individuals receiving healthcare provider recommendations and feedback, owning BP devices, or on three antihypertensive medications were more likely to engage in community BPM. To improve uptake of community BP monitoring, and ensure continuity of care, targeted interventions such as healthcare provider counseling, feedback mechanisms, and facilitating access to BP devices are recommended.