A telehealth-delivered intervention to extend the veteran HIV treatment cascade for cardiovascular disease prevention: V-EXTRA-CVD study protocol for a randomized controlled trial

HIV Res Clin Pract. 2023 Dec;24(1):2261747. Epub 2023 Oct 6.

Abstract

Background: Veterans living with HIV have up to twice the risk of atherosclerotic cardiovascular disease (ASCVD) compared to those without HIV.Objective: Our study seeks to test a non-physician led virtual self-management implementation strategy to reduce ASCVD risk among people living with HIV (PWH). We aim to conduct a randomized control trial among PWH (n = 300) with a diagnosis of hypertension (HTN) who are enrolled in Veterans Health Administration (VHA) clinics, on suppressive antiretroviral therapy (ART), randomized 1:1 to intervention vs. education control for a 12-month duration.Methods: Using human centered design approach, we have adapted a previous 5-component telehealth focused, non-physician led intervention to a Veteran population. The education control arm receives enhanced education in addition to usual care. The primary outcome is 6 mmHg reduction in systolic BP over 12-month in the intervention arm compared to the control arm. The secondary outcome is a 12-month difference in non-HDL cholesterol. While each component of our intervention has an evidence base, they have not been tested together in an HIV context.Conclusion: The proposed multicomponent intervention has the potential to improve cardiovascular outcomes in PWH using novel virtual care methods in a patient centered care approach.

Keywords: HIV; atherosclerotic cardiovascular disease; cholesterol; hypertension.

Publication types

  • Clinical Trial Protocol

MeSH terms

  • Cardiovascular Diseases* / prevention & control
  • HIV Infections* / complications
  • HIV Infections* / drug therapy
  • HIV Infections* / prevention & control
  • Humans
  • Hypertension* / complications
  • Hypertension* / therapy
  • Randomized Controlled Trials as Topic
  • Telemedicine*
  • Veterans*