Characteristics of TPT initiation and completion among people living with HIV

Overview

BACKGROUND

TB preventive treatment (TPT) reduces morbidity and mortality among people living with HIV (PLHIV). Despite the successful scale-up of TPT in Malawi, monitoring and evaluation have been suboptimal. We utilized the Malawi Population-Based HIV Impact Assessment (MPHIA) 2020–2021 survey data to estimate TPT uptake and completion among self-reported HIV-positive persons.

METHODS

We estimated the proportion of HIV-positive respondents who had ever undergone TPT, and determined the percentage of those currently on TPT who had completed more than 6 months of treatment. Bivariate and multivariable logistic regression were performed to calculate the odds ratios for factors associated with evertaking TPT. All variables were self-reported, and the analysis was weighted and accounted for in the survey design.

RESULTS

Of the HIV+ respondents, 38.8% (95% CI 36.4–41.3) had ever taken TPT. The adjusted odds of ever taking TPT were 8.0 and 5.2 times as high in the Central and Southern regions, respectively, compared to the Northern region; 1.9 times higher among those in the highest wealth quintile, and 2.1 times higher for those on antiretroviral therapy >10 years. Of those currently taking TPT, 56.2% completed >6 months of TPT.

CONCLUSION

These results suggest low TPT uptake and >6 months’ completion rates among self-reported HIV+ persons. Initiatives to create demand and strengthen adherence would improve TPT uptake.