SPONSORED RESEARCH: Integrating Hypertension and Cardiovascular Disease Care into Existing HIV Service Package in Botswana (InterCARE)
November 22, 2025
Read a Q&A Below
Professor Lisa Hirschhorn, MD, MPH at Northwestern University’s Feinberg School of Medicine Department of Medical Social Sciences (MSS) and Mosepele Mosepele, MBBS, BMedSci, MSc, University of Botswana received a R01 grant from The National Heart Lung and Blood Institute titled: “Integrating Hypertension and Cardiovascular Disease Care into Existing HIV Service Package in Botswana (InterCARE)-Statin Sub-study.”
What are the aims of the project?
The project aims to evaluate and implement a simplified, age-based statin initiation strategy for people living with HIV and hypertension (PWH/HTN) in Botswana, as an alternative to the current risk score-based approach. Specifically, it seeks to:
- Identify barriers and facilitators to statin uptake using mixed-method formative research guided by CFIR 2.0.
- Assess healthcare system readiness and optimize service delivery models—including task shifting, integrated clinic visits, and multi-month medication dispensing.
- Test the effectiveness of the age-based strategy versus risk score-based indication through a cluster randomized controlled trial embedded within the ongoing InterCARE study.
The overarching goal is to improve access, uptake, and persistence of statin therapy while maintaining blood pressure and HIV viral suppression control.
What are your next steps?
Our immediate next steps include conducting formative research across InterCARE sites to understand the contextual factors that affect statin availability and uptake. We will also map mechanisms to refine or add implementation strategies that better support age-based statin initiation among PLWH. In addition, we are preparing for the follow-up of InterCARE participants at both intervention and control sites over the next 12 months, using the RE AIM framework to measure implementation outcomes of introducing statins. Finally, we will engage healthcare workers and stakeholders through surveys and interviews to ensure readiness and fidelity in delivering the intervention and understand the variability in outcomes and impact.
What do you hope will come out of this funded research?
We hope this research will show that a simple age-based statin initiation strategy can significantly improve statin uptake among this population with hypertension. It will also generate practical insights into scalable, integrated service delivery models that align with national and global priorities for cardiovascular disease prevention in HIV populations. In addition, we aim to provide Botswana and other countries in sub–Saharan Africa and around the world with a practical roadmap to help accelerate adoption of REPRIEVE findings and meet national targets for evidence based cardiovascular disease prevention. Ultimately, we hope to support a shift in how and when statin therapy is delivered to high-risk populations so that cardiovascular events are reduced and long-term health outcomes are improved.