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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Vydáno v:	Tropical medicine and infectious disease Ročník 10; číslo 11; s. 303
Hlavní autoři:	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.
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	Switzerland MDPI AG 27.10.2025
Témata:	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
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Abstract	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.
AbstractList	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. 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.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.
Audience	Academic
Author	Luzze, Henry Dar Berger, Selma Dongo, John Paul Dlodlo, Riitta A. Nsonga, Joseph Ferroussier-Davis, Odile Mande, Ritah Muchuro, Simon Namuwenge, Proscovia Lukoye, Deus Charles, Macarthur Thekkur, Pruthu Mudoola, Denis Turyahabwe, Stavia
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Cites_doi	10.1056/NEJMoa1104875 10.1186/s12889-020-09902-z 10.1038/s41598-023-43310-8 10.1097/QAI.0b013e318251aeb4 10.1136/bmjopen-2019-029058 10.1186/s12981-024-00629-0 10.1056/NEJMoa1806808 10.5588/ijtld.15.0805 10.5588/pha.16.0102 10.1002/jia2.25803 10.1080/16549716.2019.1704540 10.5588/ijtldopen.23.0194 10.1093/intqhc/mzm042 10.1016/S0140-6736(07)61602-X 10.2147/PPA.S131314
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Title	Tuberculosis Preventive Treatment in People Living with HIV in Uganda: Facilitators and Barriers for Initiation and Completion
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