We enrolled 235 participants; Their mean age was 42.8 (±10.7) years, (167/235 (71%)) were female and, the age group 35–44 years was 35%. The prevalence of hypertension among PLHIV in Mombasa County was 25%. Factors associated with hypertension were age ≥45 years (P.R: 2.07, 95%CI: 1.14–3.77), Body-Mass-Index (BMI) 25–29.9 (P.R: 3.05, 95%CI: 1.52–6.11), BMI&amp;gt;30 (P.R: 4.8, 95%CI: 2.1–10.87), tenofovir based regimens (P.R: 0.28, 95%CI: 0.12–0.63), and opportunistic infections (P.R: 0.14, 95%CI: 0.02–1.09). On multivariable analysis, factors independently associated with hypertension were BMI 25–29.9 (A.P.R: 2.41, 95%CI: 1.30–4.42), BMI&amp;gt;30 (A.P.R: 3.37 95%CI: 1.69–6.73) and use of a tenofovir-based regimen (A.P.R: 0.32, 95%CI: 0.17–0.60). 