A systematic review of healthcare providers’ perceptions and practices in preventing cardiovascular disease among people living with HIV: a nursing- analytic synthesis

Abstract

Background: Cardiovascular disease (CVD) is a leading cause of morbidity and mortality among people living with HIV (PLWH), driven by increased life expectancy, chronic inflammation, and the metabolic effects of antiretroviral therapy. Although evidence-based prevention strategies exist, their integration into routine HIV care remains inconsistent. Nurses play a central role in delivering CVD prevention within HIV services, yet their perceptions and practices have not been comprehensively synthesised. Aim: To examine healthcare providers’ perceptions and practices regarding CVD prevention among PLWH using a nursing-analytic lens. Methods: A systematic review was conducted in line with PRISMA guidelines. CINAHL, PubMed, Embase, and Scopus were searched for English-language studies published between 2020 and 2025. Qualitative, quantitative, and mixed- methods studies examining healthcare providers’ perceptions and practices relevant to nursing were included. Methodological quality was appraised using Joanna Briggs Institute tools, and findings were synthesised narratively. Results: 15 studies met the inclusion criteria. Four themes were identified: (1) nurses’ perceptions of CVD in HIV care, (2) current prevention practices, (3) barriers to effective prevention, and (4) facilitators of good practice. While nurses recognised the importance of CVD prevention, HIV remained the dominant clinical priority, limiting implementation. Screening, lifestyle counselling, and task-shifted care were applied inconsistently due to training gaps, limited resources, time pressures, role ambiguity, and fragmented care systems. Nurse-led and integrated care models showed promise when supported by adequate training, supervision, and organisational support. Conclusion: Gaps in CVD prevention within HIV care are driven largely by structural and system-level constraints rather than lack of nursing motivation. Nurses are well positioned to lead prevention efforts, but effective integration requires explicit prioritisation of CVD within HIV services, targeted training, clear role delineation, and supportive policies. Strengthening nurse-led and integrated models may improve cardiovascular outcomes among PLWH.