A NURSE-LED INTERVENTION TO EXTEND THE HIV TREATMENT CASCADE FOR CARDIOVASCULAR DISEASE PREVENTION

The EXTRA-CVD study is focused on improving blood pressure and cholesterol treatment for people living with HIV, who are on HIV medication, through a nurse-led intervention.

Why is this study being done?

People Living with HIV are at 1.2-2 times higher risk of atherosclerotic cardiovascular disease (ASCVD) compared to uninfected individuals—a risk that persists despite viral suppression on Antiretroviral Therapy (ART). Currently, people living with HIV are sub-optimally treated for high BP and cholesterol, possibly due to low perceived risk for ASCVD or challenges in primary care coordination between HIV specialists and non-HIV providers. This study is being done to extend the HIV treatment cascade for two key cardiovascular disease risk factors—blood pressure and cholesterol—to improve uptake of guideline-based ASCVD prevention therapies.  

How does the study work?

HIV patients on suppressive ART, who have both hypertension and hypercholesterolemia, will be randomized (like with the flip of a coin) to a nurse-led intervention or education control. Control participants will receive general prevention education, which will consist of prevention education and 4 additional components (1) nurse-led care coordination, (2) Electronic Medical Record alerts and decision support (3) home BP monitoring, and (4) nurse-managed medication protocols and adherence support. All subjects will complete the same assessments at identical time-points: baseline, 4 months, 8 months and 12 months. Those in the intervention arm may be contacted at up to 2-week intervals as deemed necessary by the nurse to carry out the multi-component intervention.