Isoniazid preventive therapy adherence among HIV positive soldiers on antiretroviral therapy in Uganda

Abstract

AbstractBackgroundUganda has a heavy double burden of tuberculosis (TB) and currently ranks among the seven highest TB affected countries globally. World Health Organization (WHO) recommends isoniazid preventive therapy (IPT) for the treatment of latent TB. However, the adherence to IPT in military settings has not been well documented in Uganda.MethodsWe conducted a cross-sectional study among 300 HIV-positive clients on antiretroviral therapy (ART) at Bombo Military Hospital in Uganda. Clients were cumulatively recruited to a threshold sample. Data were entered and analysed using Epidata client v4.6.0.6 and Stata 14.0.ResultsOf the 300 clients the prevalence of IPT was 94.7% CI (92.1-97.2); adherence to IPT was associated with being: aged ≥ 50 years prevalence ratio (PR) of 1.061 and a confidence interval (CI) of 95% (1.01-1.12); married [PR: 1.438, CI: 95% (1.12-1.84)]; having social support [PR: 1.498, CI: 95% (1.17-1.92)] and the role this played in IPT adherence among married participants [PR: 0.817, CI: 95% (0.72-0.93)] are factors that were found to be significant.ConclusionThere is need for Bombo medical facility in Uganda to emphasis on strategies to improve access, retention and adherence to ART and IPT for young adults. Secondly, advocating for social support and behavioural interventions have been identified as requirement for improving IPT adherence among HIV positive soldiers. There is need for more research on the role that social support plays to reduce social stigma associated with HIV-positive patients. The findings for this Uganda study suggest that there is need to increase adherence to IPT for married participants living with HIV and this model could also be adopted in other resource constrained and low middle income countries.