# Improving hypertension care for persons with HIV in Indiana: a participatory agent-based model

> **NIH NIH R03** · TRUSTEES OF INDIANA UNIVERSITY · 2024 · $118,875

## Abstract

ABSTRACT
Cardiovascular disease (CVD) has become a leading cause of morbidity and mortality in persons with HIV
(PWH). Although clinical guidelines recommend detecting and addressing CVD risk among PWH, CVD
prevention has not been effectively implemented in routine HIV Care. Addressing this implementation gap is
critical for reducing the disproportionately greater burden of adverse CVD outcomes facing PWH. My K01
research aimed to address this gap by examining CVD risk among PWH, CVD preventive practices in HIV
care, and implementation strategies to improve these practices. My work showed CVD risk in PWH is driven by
traditional risk factors (e.g., hypertension) which HIV clinical guidelines recommend addressing. My K01
research also showed that lack of awareness about clinical guidelines, low clinician motivation to follow the
guidelines, lack of CVD preventive resources, and the clinic culture influence guideline adoption. I then
developed an agent-based model to simulate the effects of implementation strategies on these barriers: I found
education, audit and feedback, and leadership engagement are promising strategies to improve guideline
adoption. To determine if these findings are valid and aligned with current HIV care practices, my model needs
to be externally validated using data from diverse HIV care contexts. Further, to determine its acceptability and
real-world relevance, the model needs to be evaluated by HIV stakeholders and refined through participatory
modeling approaches. Thus, the overall goal of this R03 application is to externally validate and refine my K01
model through participatory agent-based modeling. First, I will externally validate the model that simulates the
effects of implementation strategies on hypertension care guideline adoption (AIM 1). Second, I will evaluate
and refine the model through participatory agent-based modeling with HIV stakeholders (AIM 2). The proposed
study responds to NHLBI’s call to explore CVD prevention in the HIV population and to optimize
implementation research to improve health. This study will contribute a tool that HIV decision makers can use
to inform their CVD prevention efforts, and a prototype implementation strategy that can be tested in real-world
HIV clinics.

## Key facts

- **NIH application ID:** 10924546
- **Project number:** 1R03HL174207-01
- **Recipient organization:** TRUSTEES OF INDIANA UNIVERSITY
- **Principal Investigator:** Karla Ivette Galaviz
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $118,875
- **Award type:** 1
- **Project period:** 2024-09-01 → 2026-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10924546

## Citation

> US National Institutes of Health, RePORTER application 10924546, Improving hypertension care for persons with HIV in Indiana: a participatory agent-based model (1R03HL174207-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10924546. Licensed CC0.

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