{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T03:45:34Z","timestamp":1752551134468,"version":"3.41.2"},"reference-count":32,"publisher":"Wiley","issue":"S3","license":[{"start":{"date-parts":[[2025,7,7]],"date-time":"2025-07-07T00:00:00Z","timestamp":1751846400000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["1UG3HL154501"],"award-info":[{"award-number":["1UG3HL154501"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Uganda's national guidelines recommend integrated HIV and hypertension care; however, integration of hypertension care into HIV differentiated service delivery (DSD) models has not been extensively described. We aimed to describe trends in DSD models for people living with HIV (PLHIV) with hypertension and to qualitatively describe the experiences of healthcare providers (HCPs) and PLHIV with hypertension after implementing integrated care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a parallel convergent mixed methods study nested in an ongoing stepped wedge cluster randomised trial in Kampala and Wakiso districts. Quantitative data (age, sex, blood pressure, DSD model, medication prescriptions) were collected from routine medical records at eight clinics implementing the enhanced care package between March 2023 and July 2024. Additionally, structured interviews were conducted at two clinics with HCPs (<jats:italic>n<\/jats:italic>\u00a0=\u00a06, 3 per clinic) and PLHIV with hypertension (<jats:italic>n<\/jats:italic>\u00a0=\u00a08, 4 per clinic). Our quantitative outcome variable was enrolment in intensive DSD models (facility\u2010based individual and group models) versus other DSDs. A generalised estimation equation was used to account for within clinic correlation and repeated measures within participants over time. Inductive thematic analysis was applied to the qualitative data using the Consolidated Framework for Implementation Research.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 3164 PLHIV with hypertension accessed care at the eight clinics. Median age was 46 years (IQR 38\u201356); more than two\u2010thirds were female. There was considerable heterogeneity across clinics in the use of DSD models during the study period. Overall, use of intensive models increased over time (OR 1.127 [1.059\u22121.199] per month). However, two clinics showed significant time interaction effects (Wald test \u03c7<jats:sup>2<\/jats:sup> (7)\u00a0=\u00a069.94, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001), with a decrease in the intensive models over time. HCPs and PLHIV observed that integrating hypertension care was easily adaptable in some models, while more challenging in others. The availability of resources and synchronisation of HIV and hypertension visits facilitated the integration of hypertension care within the HIV DSD models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The integration of hypertension management into HIV DSD models is both feasible and adaptable; however, it requires transitioning PLHIV between various models based on clinical needs. To facilitate this process, comprehensive client education by the HCPs is necessary.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical Trial Number<\/jats:title><jats:p>clinicaltrials.gov # NCT05609513<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.26499","type":"journal-article","created":{"date-parts":[[2025,7,7]],"date-time":"2025-07-07T10:36:42Z","timestamp":1751884602000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Early findings from the integration of hypertension care into differentiated service delivery models for HIV in Uganda: a mixed\u2010method study"],"prefix":"10.1002","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4838-0834","authenticated-orcid":false,"given":"John Baptist","family":"Kiggundu","sequence":"first","affiliation":[{"name":"Infectious Diseases Research Collaboration Kampala 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Collaboration Kampala Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7600-7722","authenticated-orcid":false,"given":"Savio","family":"Mwaka","sequence":"additional","affiliation":[{"name":"Infectious Diseases Research Collaboration Kampala Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3343-146X","authenticated-orcid":false,"given":"Florence","family":"Ayebare","sequence":"additional","affiliation":[{"name":"Infectious Diseases Research Collaboration Kampala Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine","family":"Kiwala","sequence":"additional","affiliation":[{"name":"Infectious Diseases Research Collaboration Kampala Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evelyn N.","family":"Magambo","sequence":"additional","affiliation":[{"name":"Infectious Diseases Research Collaboration Kampala Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerald","family":"Mutungi","sequence":"additional","affiliation":[{"name":"Department of Non\u2010Communicable Diseases Ministry of Health Kampala Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isaac","family":"Ssinabulya","sequence":"additional","affiliation":[{"name":"Makerere University Joint AIDS Program Kampala Uganda"},{"name":"Uganda Heart Institute Kampala Uganda"},{"name":"Uganda Initiative for Integrated Management of Non\u2010Communicable Diseases Kampala Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4006-4650","authenticated-orcid":false,"given":"Donna","family":"Spiegelman","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Center for Methods on Implementation and Prevention Science (CMIPS) Yale School of Public Health New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Kayima","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Makerere University Kampala Uganda"},{"name":"Uganda Heart Institute Kampala Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4216-0083","authenticated-orcid":false,"given":"Martin","family":"Muddu","sequence":"additional","affiliation":[{"name":"Infectious Diseases Research Collaboration Kampala Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeremy I.","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Uganda Initiative for Integrated Management of Non\u2010Communicable Diseases Kampala Uganda"},{"name":"Section of General Internal Medicine Yale School of Medicine New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne 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