Improving retention along the hypertension care cascade and reducing cardiovascular risk among people with HIV who use a safety net clinic

University Of California, San Francisco, San Francisco CA

Investigators

Abstract

ABSTRACT Hypertension (HTN) is among the strongest risk factors for cardiovascular disease and myocardial infarction, but only one-third of people with HIV (PWH) who receive care at a safety net clinic achieve hypertension control. People with severe financial challenges, particularly those with unmet subsistence needs like unstable housing and food insecurity, have higher rates of HTN and cardiovascular events in this setting. However, we still cannot pinpoint exactly how unmet subsistence needs influence where or why patients drop off the HTN care cascade. Here we propose a study among safety net HIV clinic patients. It uses an explanatory sequential design that includes quantitative survey data and qualitative contextual information. Our goal is to understand each stage of the HTN care cascade (diagnosis, treatment, and control) and overall cardiovascular disease risk among PWH who use a safety net clinic, emphasizing the unique HTN care needs of people with severe financial challenges. Results will be immediately usable by HIV safety net clinics; they will inform HIV/HTN integrated health care delivery models and the development of future HTN interventions.