What is the clinical evidence from this study?

Study design: Meta-Analysis. Population: Hypertension in People Living with HIV (n=32286). Intervention: Hypertension screening and treatment. Primary outcome: Prevalence of hypertension (95% CI 21%-28%).

What does this research mean for the field?

Hypertension affects 25% of people living with HIV in sub-Saharan Africa, yet only 34% receive treatment and 19% achieve blood pressure control due to patient, provider, and health system gaps. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

December 17, 2025International Journal of Public Health1 citationsOpen Access

Burden and Challenges of Managing Hypertension in People Living with Human Immunodeficiency Virus (HIV) Infection in Sub-Saharan Africa: A Mixed Systematic Review and Meta-Analysis

FNFrancis Duhamel Nang NangUniversité de Dschang LKLiliane Mfeukeu KuatéUniversité de Yaoundé I ADAnastase DzudiéElectrophysiology

Key Result

Hypertension affected 25% of people living with HIV in sub-Saharan Africa, yet only a small fraction received treatment and 19% achieved blood pressure control.

Study Design

Type

Meta-Analysis (n=32,286)

Multicenter

Yes

Structured PICO

What is the burden of hypertension, and the challenges encountered in the prevention cascade among people living with HIV (PLHIV) in sub-Saharan Africa?

Population

31 studies pooling 32,800 people living with HIV (PLHIV) aged 18 years and above in sub-Saharan Africa. Mean age 41.6 years, 72% women.

Outcome

Prevalence of hypertension, proportion screened, proportion receiving treatment, and proportion achieving blood pressure control

Despite high hypertension prevalence and screening rates among PLHIV in sub-Saharan Africa, treatment initiation and blood pressure control remain alarmingly low due to patient, provider, and health system barriers.

Limitations

Absence of studies from some sub-Saharan African countries may lead to a partial and unrepresentative view.
Included studies focused on a limited sample of people living with HIV in sub-Saharan Africa.
Scarcity of data on the treatment and control of hypertension.

Abstract

Objectives: Poor hypertension prevention among people living with HIV (PLHIV) in sub-Saharan Africa may undermine progress in HIV prevention achieved within this population. This review synthesizes data on the prevalence, diagnosis, treatment, control, and challenges related to hypertension prevention among PLHIV in SSA. Methods: A mixed-method systematic review with meta-analysis was conducted from January to December 2024. Data analysis was performed using random-effects modeling stratified by age and sex, along with thematic analysis. The JBI critical appraisal tool was used to assess study quality. Results: A total of 31 studies, including 32286 PLHIV (±37 years old), were included. Hypertension affected 25% 95% CI, 21%-28% of PLHIV, yet only 34% 95% CI, 11%-64% of cases received treatment, and 19% 95% CI, 3%-34% had controlled blood pressure, despite BP measurement in 95% 95% CI, 89%-100% of them. Conclusion: Hypertension prevention challenges stem from patient-related factors, healthcare providers, and health system gaps. Despite the high prevalence of hypertension among PLHIV, treatment initiation and blood pressure control rates remain low. Strengthening the integration of HIV and hypertension care services is urgently needed.

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