Integration of Hypertension Management into HIV Care in Nigeria: A Task Strengthening Strategy

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Abstract The “Integration of Hypertension Management into HIV Care in Nigeria: A Task Strengthening Strategy” (TASSH NIMR) parent study is an ongoing clinical effectiveness implementation trial that evaluates the effectiveness of an implementation strategy to integrate a task-strengthening strategy for hypertension control (TASSH) in HIV clinics in Lagos State (R01HL147811). In response to NOT-OD-21-020, we propose this administrative supplement, “Establishing an Ethics Learning Collaborative for HIV-Hypertension Integration through a TAsk Strengthening Strategy for Hypertension Control in Lagos State, Nigeria” (E-LinC TASSH). E-LinC TASSH will leverage the TASSH NIMR Steering Committee to form an Ethics Learning Collaborative (ELC), which will identify, analyze, and characterize ethical considerations for implementing a practice facilitation–guided task- strengthening approach to couple hypertension and HIV treatment within primary health care centers throughout Lagos State. Additionally, E-LinC TASSH will develop an ethics-informed strategy for scaling up, spreading, and sustaining the TASSH NIMR intervention in HIV clinics throughout Lagos State. To better appreciate an implementation research informed learning collaboratives to advance bioethical considerations in HIV- hypertension integration, this supplement will also evaluate use of an ethics focused learning collaborative. Expansion into this area of bioethics research will allow us to comprehensively understand and contextualize ethical considerations of implementing this treatment and management model. This bioethics research will enable us to develop strategies for managing and solving ethical challenges arising in our implementation research and scale-up of the TASSH NIMR strategy. TASSH NIMR is currently in the pre-implementation or planning phase and will begin recruitment in time for the proposed research to enhance the intervention's impact and to inform the next steps for scaling up, spreading, and sustaining the intervention within the Lagos State primary healthcare network. In addition to engaging in the proposed bioethics research, E-LinC TASSH will build research ethics and bioethics capacity among ELC members through expert-facilitated discussions and activities involved in developing the survey, engaging stakeholders, interpreting findings, and integrating this new knowledge into practical strategies. Per instructions in NOT-OD-21-020, this supplement is specific to bioethics research and capacity building.