Background Successful HIV treatment programs have turned HIV into a chronic condition, but noncommunicable diseases such as hypertension jeopardize this progress. Hypertension control rates among people with HIV (PWH) are low owing to gaps in patient awareness, diagnosis, efective treatment, and management of both conditions at sepa‑ rate clinic visits. Integrated management, such as in our study, InterCARE, can enhance HIV-hypertension integration and blood pressure (BP) control.

Methods Our pilot study was conducted in two Botswana HIV clinics between October 2021 and November 2022. Based on our formative work, we adopted three main strategies; Health worker training on HTN/cardiovascular dis‑ ease (CVD) management, adaptation of HIV Electronic Health Record (EHR) for HTN/CVD care, and use of treatment partners to support PWH with hypertension for implementation. We employed the Reach, Efectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework to assess implementation efectiveness and outcomes for BP control at baseline, 6 and 12 months. HIV viral load (VL) suppression was also measured to assess impact of integra‑ tion on HIV care.

Results We enrolled 290 participants; 35 (12.1%) were lost to follow-up, leaving 255 (87.9%) at 12-months. Median age was 54 years (IQR 46–62), and 77.2% were females. Our interventions signifcantly improved BP control to<140/90 mmHg (or<130/80 mmHg if diagnosis of diabetes or chronic kidney disease), from 137/290 participants, 47.2% at baseline to 206/290 participants, 71.0%, at 12 months (p<0.001). Among targeted providers, 94.7% received training, with an associated signifcant increase in counseling on exercise, diet, and medication (all p<0.001) but EHR use for BP medication prescribing and cardiovascular risk factor evaluation showed no adoption. In the intentionto-treat analysis, HIV VL suppression at 12 months decreased (85.5% vs 93.8%, p=0.002) due to loss to follow-up

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