Hypertension Control and Retention in Care Among HIV-Infected Patients: The Effects of Co-located HIV and Chronic Noncommunicable Disease Care

BACKGROUND: As the non-communicable disease (NCD) burden is rising in regions with high HIV prevalence, patients with comorbid HIV and chronic NCDs may benefit from integrated chronic disease care. There are few evaluations of the effectiveness of such strategies, especially those that directly leverage and extend the existing HIV care system to provide co-located care for NCDs. SETTING: Academic Model of Providing Access to Healthcare (AMPATH), Kenya, provides care to over 160,000 actively enrolled patients in catchment area of 4 million people. METHODS: Using a difference-in-differences design, we analyzed retrospective clinical records of 3603 patients with comorbid HIV and hypertension during 2009–2016 to evaluate the addition of chronic disease management (CDM) to an existing HIV care program. Outcomes were blood pressure (BP), hypertension control, and adherence to HIV care. RESULTS: Compared to the HIV standard of care, the addition of CDM produced statistically significant, though clinically small improvements in hypertension control, decreasing systolic BP by 0.76mmHg (p1 year improved by 7 percentage points (p6months increased by 10.5 percentage points (p