Tuberculosis Preventive Treatment in People Living with HIV in Uganda: Facilitators and Barriers for Initiation and Completion

Tuberculosis preventive treatment (TPT) is a mainstay for reducing the tuberculosis (TB) burden among people living with human immunodeficiency virus (PLHIV). Context-specific challenges hinder TPT uptake and completion among PLHIV. During 2022–2024, a mixed-methods design was used to evaluate the T...

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Published in:Tropical medicine and infectious disease Vol. 10; no. 11; p. 303
Main Authors: Mande, Ritah, Thekkur, Pruthu, Mudoola, Denis, Nsonga, Joseph, Dongo, John Paul, Muchuro, Simon, Turyahabwe, Stavia, Luzze, Henry, Namuwenge, Proscovia, Dar Berger, Selma, Lukoye, Deus, Charles, Macarthur, Ferroussier-Davis, Odile, Dlodlo, Riitta A.
Format: Journal Article
Language:English
Published: Switzerland MDPI AG 27.10.2025
Subjects:
4S screening
Analysis
Collaboration
Data collection
Disease control
Drug therapy
Health facilities
HIV
HIV (Viruses)
HIV patients
Human immunodeficiency virus
Medical personnel
Medicine, Preventive
Pharmacovigilance
PLHIV
Preventive health services
Qualitative research
Rifapentine
TPT adherence
TPT completion
TPT initiation
Tuberculosis
tuberculosis preventive treatment
United States
Uganda
Switzerland
United States > US
TPT adherence
TPT completion
PLHIV
tuberculosis preventive treatment
operational research
4S screening
TPT initiation
ISSN:2414-6366, 2414-6366
Online Access:Get full text
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Summary:Tuberculosis preventive treatment (TPT) is a mainstay for reducing the tuberculosis (TB) burden among people living with human immunodeficiency virus (PLHIV). Context-specific challenges hinder TPT uptake and completion among PLHIV. During 2022–2024, a mixed-methods design was used to evaluate the TPT cascade and explore its facilitators and barriers among PLHIV availing care from 12 PEPFAR-supported health facilities in Uganda. The quantitative component included analysis of routine programmatic data, and the qualitative component included focus group discussions and in-depth interviews with healthcare workers and PLHIV. A total of 1349 PLHIV were enrolled in the evaluation. Among PLHIV newly initiated on ART (≤3 months), 74% started TPT, and 98% of them completed it. In PLHIV already on ART, 87% had initiated TPT (76% before and 11% during this evaluation), with a treatment completion rate of 98%. The facilitators for TPT implementation included access to shorter TPT regimens, integration of services, and adherence counseling. Barriers included knowledge gaps, pill burden, TPT drug stock-outs, and documentation inconsistencies. The TPT completion rate was higher than the national target (90%), but the TPT initiation remains low. Improved access to shorter regimens, adherence counseling, better documentation, and service integration can sustain the completion rate and improve the initiation rate in Uganda and possibly elsewhere.
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ISSN:2414-6366
2414-6366
DOI:10.3390/tropicalmed10110303