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Exploring barriers to hypertension medication adherence among people living with HIV enrolled in the iHEART-SA trial:

Wellington Maruma1,2, E Oladimeji3, A Nyatela3

  • 1Department of Global Public Health and Bioethics, Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, PO Box 85500, Utrecht, 3508 GA, The Netherlands. T.W.Maruma@umcutrecht.nl.

BMC Public Health
|December 4, 2025
PubMed

Insights

Adherence to hypertension medication for people living with HIV (PLHIV) is hindered by care delays and knowledge gaps. Enhancing social support and integrating hypertension care into HIV services can improve adherence and health outcomes.

Area of Science:

  • Public Health
  • Cardiovascular Medicine
  • Infectious Disease

Background:

  • Hypertension presents a significant cardiovascular risk, particularly for people living with HIV (PLHIV) in Sub-Saharan Africa.
  • This study addresses the dual burden of hypertension and HIV in Johannesburg, South Africa.

Purpose of the Study:

  • To explore barriers and enablers of hypertension medication adherence among PLHIV.
  • To identify factors influencing adherence in primary healthcare settings.

Main Methods:

  • Qualitative study design utilizing the Theoretical Domains Framework (TDF).
  • Data collected via interviews and focus group discussions with PLHIV and healthcare providers.
  • Inductive thematic analysis of transcribed data, categorized using the TDF.

Main Results:

  • Four key themes emerged: delays in care, knowledge gaps, social support, and service integration.
  • Identified barriers include reliance on traditional medicine, high pill burden, socio-economic issues, and long waiting times.
  • Facilitators for adherence include social support and targeted educational interventions.

Conclusions:

  • A multifaceted approach is needed to improve hypertension medication adherence among PLHIV.
  • Interventions should focus on health literacy, social support, and integrating hypertension care into HIV services.
  • Optimizing adherence is crucial for improving overall health outcomes in this population.
Abstract

Keywords:
HIVHypertensionMedication adherencePrimary healthcareSouth africaTheoretical domains framework

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