What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: HIV and perceived risk of hypertension (n=392). Intervention: Urban residence vs. Rural residence. Primary outcome: Low perceived risk of hypertension (APR 0.55, 95% CI 0.40-0.76, p=<0.001).

What question did this study set out to answer?

This study aims to determine the prevalence of low perceived risk of hypertension and the factors influencing this perception among adults living with HIV in Eastern Uganda.

May 19, 2026Open Access

Prevalence and factors associated with low perceived risk of hypertension among adults living with HIV in Eastern Uganda

Q: What are the key findings of this study?

Urban residence was associated with a 45% lower likelihood of having a low perceived risk of hypertension compared to rural residence among adults living with HIV.

Q: What question did this study set out to answer?

This study aims to determine the prevalence of low perceived risk of hypertension and the factors influencing this perception among adults living with HIV in Eastern Uganda.

Key Result

Urban residence was associated with a 45% lower likelihood of having a low perceived risk of hypertension compared to rural residence among adults living with HIV.

Key Points

This study aims to determine the prevalence of low perceived risk of hypertension and the factors influencing this perception among adults living with HIV in Eastern Uganda.
Conducted a facility-based cross-sectional study among adult PLHIV in Eastern Uganda.
Excluded 30 participants with prior hypertension diagnosis to focus on perceived risk.
Used modified Poisson regression to identify factors associated with low perceived risk of hypertension.
29% of participants reported low perceived risk of hypertension.
Urban residence (APR=0.55; 95% CI: 0.40–0.76) and tertiary education (APR=0.72; 95% CI: 0.52–0.99) were linked to a lower likelihood of low perceived risk.
Absence of NCD comorbidities (APR=1.38; 95% CI: 1.00–1.89) and lack of family history of hypertension (APR=1.42; 95% CI: 1.20–1.68) were associated with a higher likelihood of low perceived risk.

Study Design

Type

Cross-Sectional (n=392)

Multicenter

Yes

Structured PICO

Population

Adult persons living with HIV (PLHIV) attending public health facilities in Eastern Uganda, excluding those with known hypertension.

Outcome

Prevalence of low perceived risk of hypertension and its associated factorspatient reported

More than one-quarter of adults living with HIV in Eastern Uganda have a low perceived risk of hypertension, indicating a need for tailored risk communication to support preventive behaviors.

Main Result

Effect estimate: APR 0.55 (95% CI 0.40-0.76)

p-value: p=<0.001

Limitations

Purposive selection of higher-volume public health facilities and consecutive recruitment may have introduced selection bias.
Self-reported variables may have been subject to recall or social desirability bias.
Exclusion of participants with a prior diagnosis of hypertension was based on self-report without objective verification, potentially introducing misclassification bias.

Abstract

Persons living with HIV (PLHIV) face an increased risk of hypertension due to chronic inflammation, long-term antiretroviral therapy, and ageing. Adoption of preventive behaviours partly depends on individuals’ awareness and perception of their susceptibility to hypertension. However, evidence on the prevalence and determinants of low perceived risk of hypertension among PLHIV remains limited in Uganda and similar sub-Saharan African settings. This study assessed the prevalence of low perceived risk of hypertension and its associated factors among adult PLHIV in Eastern Uganda. We conducted a facility-based cross-sectional study among adult PLHIV attending public health facilities in Eastern Uganda. Participants who self-reported a prior diagnosis of hypertension (n = 30) were excluded from the analytic sample because the study focused on perceived risk of developing hypertension among those without known hypertension. Perceived risk was assessed using absolute, conditional, and comparative risk questions on a 4-point Likert scale. Scores were categorized into low and high perceived risk of hypertension using the overall median score. Modified Poisson regression was used to identify factors associated with low perceived risk of hypertension. Overall, 29% of participants had low perceived risk of hypertension. Urban residence (APR = 0.55; 95% CI: 0.40–0.76), tertiary education (APR = 0.72; 95% CI: 0.52–0.99), and higher hypertension knowledge (APR = 0.98; 95% CI: 0.97–0.99) were associated with a lower likelihood of low perceived risk of hypertension. Conversely, absence of NCD comorbidities (APR = 1.38; 95% CI: 1.00–1.89) and lack of a family history of hypertension (APR = 1.42; 95% CI: 1.20–1.68) were associated with a higher likelihood of low perceived risk of hypertension. More than one-quarter of PLHIV had low perceived risk of hypertension, indicating a potential gap in perceived susceptibility within a high-risk population. Tailored, community-informed hypertension risk communication integrated into routine HIV care may improve perceived susceptibility and support preventive behaviours.

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