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South Africa: IHEART-SA

Project Overview

Study title: Integrating HIV and hEART health in South Africa (iHEART-SA)

Research question: How does an intervention package aimed at enhancing hypertension diagnosis and management in people with HIV improve the delivery of guideline-recommended care in primary health care clinics in Gauteng, South Africa, and hypertension control among patients?

Study design: Type-2 hybrid effectiveness-implementation, stepped wedge cluster randomized trial

Setting/location: City of Johannesburg, Region F (9 clinics)

Study participants: Patients over 18 years of age who have been diagnosed with HIV and hypertension, health care workers

Contact PI: WD Francois Venter, University of the Witwatersrand (South Africa)

MPIs: Mohammed K. Ali and Vincent C. Marconi, Emory University (USA)

Collaborating institutions: Emory University (USA), Harvard University (USA), University Medical Centre Utrecht (Netherlands), University of the Witwatersrand (South Africa)

Supporting/advisory institutions: Adrenergy (South Africa), The Aurum Institute (South Africa), Indiana University (USA), South African National Department of Health, Technical University of Munich (Germany), Treatment Action Campaign (South Africa), University of KwaZulu-Natal (South Africa)


The iHEART-SA study has the dual objective of testing both an implementation strategy and a clinical intervention package. The primary objectives are informed by the RE-AIM framework:

  1. Assess the short- and long-term effects of an implementation strategy (i.e., health care worker intervention) on fidelity to hypertension screening and treatment among health care workers
  2. Assess the short- and long-term effects of a clinical intervention package (i.e., patient-level intervention) on blood pressure control among patients with HIV and hypertension

During the active intervention period, which will last between six and 12 months depending on the clinic, the iHEART-SA intervention model will be initiated and implemented by dedicated research staff who will train clinic staff to take over the process toward the end of the period. The iHEART-SA intervention model includes the following: identifying and preparing champions (clinic care coordinators) to support, market, and drive implementation of hypertension screening and treatment; training healthcare workers to measure, diagnose, and treat hypertension properly; patient education; and improvements to clinic flow and information systems to ensure these new processes are being followed properly. 

More details on the project can be found on the Ezintsha website.

· Meet Our Team ·

Francois Venter, MD,PhD

University of the Witwatersrand, Johannesburg, South Africa

Mohammed Kumail Ali, MD

Emory University, Atlanta, Georgia, USA

Vincent Charles Marconi, MD

Emory University, Atlanta, Georgia, USA

IHEART-SA is funded by the National Heart, Lung, and Blood Institute (NHLBI), a division of the US National Institutes of Health (NIH), through grant UH3-HL156388.