Acceptability of healthy lifestyle recommendations for blood pressure reduction, and its associated factors, among hypertensive people living with HIV in a tertiary HIV clinic in Kampala, Uganda

Abstract

Introduction: Hypertension is a significant public health problem with a prevalence ranging between 11% and 29% among people living with HIV (PLWH) in Uganda. Healthy lifestyle recommendations are essential in the prevention and management of hypertension, although determinants of their uptake may differ by regional/cultural context. I aimed to assess the acceptability of healthy lifestyle recommendations for blood pressure reduction among PLWH and hypertension at the Infectious Diseases Institute (IDI), Kampala Uganda, guided by the health belief model (HBM). Methods: A facility-based cross-sectional study was conducted among PLWH aged ≥ 18 years with hypertension receiving care at IDI. I collected data on socio-demographics, clinical history and patients’ ratings on the HBM. Healthy lifestyle recommendations assessed included dietary intake, physical activity, alcohol reduction and smoking cessation. Summary statistics were used to describe the data while logistic regression was used to determine the factors associated with acceptability of the interventions. Results: The study enrolled 427 participants with a mean age of 53 years (SD± 9.4), 57% of them females and 26% obese. Overall, 26.5% of the participants had good knowledge on healthy lifestyle recommendations, 86.9% considered healthy lifestyle recommendations acceptable while 24.4% engaged in healthy lifestyle practices. Urban residents [AOR: 0.35, 95% CI (0.14-0.90)] and participants with high self-efficacy [AOR: 162, 95% CI (37.1-704.4)] were significantly associated with acceptability. Conclusion: This study showed that acceptability of healthy lifestyle recommendations was high, however, knowledge and healthy lifestyle recommendations were low among PLWH and hypertension. Behaviour change programs, including intensive health education, targeting PLWH should be advocated for and integrated into routine HIV care to manage hypertension among PLWH in Uganda.