A nurse-led intervention to extend the HIV treatment cascade for cardiovascular disease prevention (EXTRA-CVD)

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Abstract In the HIV/AIDS treatment cascade model, people living with HIV (PLHIV) who are engaged in care are more likely to adhere to HIV Anti-Retroviral Therapy (ART) and achieve durable viral suppression. In order to achieve viral suppression, near perfect adherence to ART is required. Even though PLHIV are responsible for medication adherence, in HIV treatment guidelines, HIV care providers play an important role in encouraging and monitoring ART adherence. After achieving viral suppression, PLHIV and providers have an important opportunity to focus on preventing other non-AIDS comorbidities. Among non-AIDS defining conditions, PLHIV are at a higher risk for atherosclerotic cardiovascular disease (ASCVD) than the general population. It is therefore critical for these high-risk individuals to maintain optimal adherence to medications to reduce the likelihood of advanced atherosclerosis and subsequent cardiac events. However, little is known about medication adherence for treatment of ASCVD risk factors such as hypertension and hyperlipidemia for PLHIV who have achieved viral suppression. In this 3-year diversity supplement, the candidate proposes to use qualitative methods to explore intrinsic and extrinsic motivational factors that facilitate optimal hypertension and hyperlipidemia medication adherence among PLHIV who have achieved durable viral suppression and identify HIV healthcare provider attitudes and practice norms among other factors that impact intentions to monitor and encourage adherence to hypertension and hyperlipidemia medications in PLHIV who have achieved viral suppression. The candidate also proposes to use quantitative methods to assess medication adherence for hypertension and hyperlipidemia for participants enrolled in the parent study.