Date of Award

January 2022

Document Type


Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

Sheela Shenoi


Background: Over the past three decades, the prevalence of hypertension has increased in sub-Saharan Africa, paralleling the HIV/AIDS epidemic. The aim of this study is to assess the relationship between HIV status and elevated blood pressure in a rural South African community. Methods: A secondary analysis was conducted from a community-based screening program providing TB/HIV/blood pressure/glucose screening in the rural sub-district of Msinga, KwaZulu-Natal, South Africa from 2011 - 2017. Descriptive analyses were used to characterize the frequency of measured and self-reported hypertension, HIV status, and sociodemographic variables. Multivariable logistic regressions were used to estimate the relationship between HIV status and elevated blood pressure, controlling for sociodemographic variables. Results: Among 4983 adults, 75% were female, 83% received monthly government grants, 12% were identified as living with HIV. Additionally, 36% had elevated blood pressure at time of screening, 18% reported a previous diagnosis of hypertension, and 16% reported treatment for known hypertension. In univariable analysis, participants with hypertension were more likely to be older, female, receive monthly government grants, not use tap water, and be HIV negative (all p < 0.05). Multivariable logistic regression showed elevated blood pressure was significantly associated with older age (OR 1.06 [1.06-1.07]), identifying as female (OR 1.37 [1.18 - 1.61]), and a lesser odds of HIV positive status (OR 0.63 [0.52 - 0.77]). Receipt of monthly grants and use of tap water were not significant. Conclusions: A high proportion of community members had elevated blood pressure in a community screening initiative. Those living with HIV were less likely to have elevated blood pressure. While the exact mechanisms for this difference require further research, community-based screenings offer a way to improve identification of these two conditions and facilitate improved health outcomes overall.


This thesis is restricted to Yale network users only. It will be made publicly available on 05/19/2024