The research was conducted by the Managing Hypertension among People Living with HIV: An Integrated Model (MAP-IT) study team, led by prominent researchers Daniel Henry, Anyiekere Ekanem, and Dike Ojji. Their investigation discovered that a significant percentage of individuals accessing HIV services were newly diagnosed with hypertension, a condition that had previously gone undetected.
The MAP-IT study screened individuals during the 2023 World AIDS Day commemoration, annually observed on December 1st. The study, titled "Integrating Non-Communicable Diseases Awareness Campaign into Periodic Human Immunodeficiency Virus Awareness Campaign: Lessons from Events of World AIDS Day in Akwa Ibom State, Nigeria," was officially published on May 6th.
Akwa Ibom's HIV Burden and the Call for Integrated Care
Akwa Ibom State, where the study was conducted, ranks third in Nigeria for the highest number of people living with HIV. According to the 2024 HIV Spectrum Estimates by the National Agency for the Control of AIDS (NACA), Rivers State leads with 208,767 HIV cases, followed by Benue State with 202,346, while Akwa Ibom records a substantial 161,597 cases. This significant HIV prevalence in the state further highlights the critical importance of integrating hypertension screening into HIV-related services.
The MAP-IT trial and its supplementary study, LINK2MAP-IT, receive funding from the US National Heart, Lung, and Blood Institute (NHLBI), enabling this vital research.
Working in collaboration with the Akwa Ibom State Agency for the Control of AIDS, the MAP-IT team adopted a nurse-led, community-based approach. They partnered with 22 community-based organizations (CBOs) already engaged in HIV service delivery. These organizations received training and were equipped with semi-automated blood pressure monitors and educational materials. This empowerment allowed them to conduct screenings, provide lifestyle counseling, and facilitate referrals to primary healthcare centers for necessary follow-up care.
Evolving Public Health Campaigns for Broader Impact
According to Mr. Ojji, who is the lead investigator and head of the Cardiovascular Research Unit at the University of Abuja, the study's findings expose a troubling gap in cardiovascular disease (CVD) awareness among PLWHIV. This reinforces the compelling need to comprehensively address non-communicable diseases (NCDs) within this vulnerable population.
The researchers suggest that traditional World AIDS Day campaigns, which have historically focused on testing, treatment, and stigma reduction, must evolve. They advocate for the inclusion of routine screening for other chronic conditions such as hypertension, diabetes, and lipid disorders as a standard practice.
"The longevity afforded by access to antiretroviral therapy is now revealing the hidden toll of comorbid conditions such as hypertension among PLWHIV," the authors noted in their publication. They emphasized that without early detection and timely treatment, these preventable risk factors could severely compromise the significant health gains already achieved through dedicated HIV care.
The MAP-IT findings present a compelling argument for revisiting public health campaigns, especially in regions like sub-Saharan Africa where the burden of non-communicable diseases continues to rise alongside infectious diseases. The study proposes that these campaigns should transform into "multi-disease platforms that save time, resources, and ultimately, lives," promoting a more holistic approach to public health.