Brief Statement

Uganda:  Effective, cost-effective, scalable, sustainable, and equitable implementation strategies to improve care for people living with HIV and co-morbid hypertension in sub-Saharan Africa are urgently needed. Our PULESA study compares the effectiveness, scalability, and cost-effectiveness of a lower-resource intensive vs. a higher- resource intensive strategy to integrate hypertension care into HIV clinics in Uganda. A stepped-wedge cluster randomized trial of 16 clinics from Kampala and Wakiso is used to determine the effectiveness of implementation strategies to improve BP cascade metrics. Clinics are randomized to receive free and consistent access to diagnostic equipment and evidence-based antihypertensive drugs (HTN-BASIC), with and without a multi-component implementation strategy developed (HTN-PLUS).  In addition to scalability as the main implementation outcome, acceptability, adoption, implementation climate and sustainability in cots-effectiveness is evaluated.

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