biostudies-literatureSchmutz RNIAID NIH HHSe018469https://www.ebi.ac.uk/biostudies/studies/S-EPMC12853508biostudies-literatureUnknown11(1)<h4>Introduction</h4>Towards the 'End TB Strategy' targets, the WHO recommends the provision of tuberculosis (TB) preventive therapy (TPT) for high-risk groups including people living with HIV (PLWH). 3 years after the release of the updated 2020 WHO guidelines, we investigated the implementation of TPT services at HIV clinics in low-income and middle-income countries (LMICs), focusing on TB screening, populations eligible for TPT and available TPT regimens.<h4>Methods</h4>In 2023, we surveyed HIV care clinics in the International Epidemiology Databases to Evaluate AIDS consortium in Africa, the Asia-Pacific and Latin America and the Caribbean. We used descriptive statistics to summarise TPT implementation according to WHO guidelines and multivariable logistic regression models to estimate associations with clinic characteristics.<h4>Results</h4>Of 172 HIV clinics included, 142 (83%) were in Africa, 22 (13%) in the Asia-Pacific and 8 (5%) in Latin America; 108 (63%) were located in urban areas. After ruling out active TB, TPT was reportedly offered to PLWH (122 clinics, 71%), household contacts of individuals with active TB (120 clinics, 70%) and other high-risk populations. TPT for PLWH was more frequently available in clinics in lower-income and low-middle-income countries, in high TB burden countries, and in district hospitals compared with other facility types. Clinics reported use of isoniazid-based (160 clinics, 93%) and shorter rifamycin-based (129 clinics, 75%) TPT regimens. Reported barriers to TPT initiation included patient refusal at 71 (41%) and drug shortages at 67 (39%) clinics.<h4>Conclusions</h4>TPT was available at most HIV care clinics in LMICs but further efforts are needed to reinforce WHO recommendations and ensure that TPT is consistently accessible to people at higher risk of developing active TB, especially PLWH.BMJ global healthThe implementation of tuberculosis preventive therapy in HIV care clinics in Africa, Asia and Latin America: a multiregional site survey.PMC12853508U01 AI069923U01 AI069911U01 AI069924U01 AI096299U01 AI069907U01 AI069918U01 AI069919Pov CDu QTSemeere ADo CDHoagland BBun VKagaju RDouglas DBenard CLidie TGahimbare ERyder NPerson AHeng TKN'Goran HCSuwanlerk TMusiku MSang EKasozi CKoukha UIUwineza PRussell DRutakulemberwa HMugisha DGTedaldi ENovak RTrang TDusabe CNakato PNdizeye ZPooda GTom SKhol VNtibigarura JMCarr APasayan MKCornell MCanicious KBen Muhoza AMSchreuder CSmith ADMurenzi GEdnah KTukashaba JMejia FWanza MLwin HKitetele FOwiti NUwamahoro MDUwamahoro MCNamembe SWafula ICrust MTwizere CKlein MKweyu MUwumaliya BKubwimana GFarel CColeta RNMukoya JAlphonce RPoongulali SSantiago CFLLeprince EAbrao PMinga AKJaquet ADoudtchitzky NChelal ECastelnuovo BXaba NWawire KAMoukouba RChebet JFenner LNeba ENPongprapass STanuma JNimbona PEnane LANijhawan ASchmutz ROgoti JMBonheur AHodge TWWoolley IDuda SNMultani AChitalikar AMuyindike WO'Reilly MMonteiro MPFleming JMuyango FMutiembu MNdi NMahinga NNsonde DMKhuwuwan SIniguez ALHadijja NEzechi OCortes CMFatti GMujunu DHabumuremyi JBFlitcroft TO'Bryan JTuyishime EPetersen BNguyen TTOba AAChidambaram SKSakong FYotebieng MCesar CSulaiman LCortes CPNisana NDavid LHabiryayo TSithole JCManiriho GSundari SNiyonzima JHaruna IKSweeney GChumla LSanmeema NPalella FMafoua AMungwa GAlubala GNOng JBenavides RVChen HPLebakeng LEmukule PPatrick ATiendrebeogo TFirnhaber CSNassanga Sarah JGoetz MBMayamba WTorres SJREbasone PVDuffy JNamayanja JDelgado NBallif MAlam AMartin Redmond ASafina NNdumuhire JBurkholder GANiragira SPSsewankambwe NNamagogwe RNyenti ANicholas JNyiramahirwe RMkombachepa LChirchir JPham TNBeugre DBopage RGotuzzo EMatovu JMKamugwawa RUwambaje MVButeera AMwaba DAyinkamiye JMuhindo SPoda ACox SRRubega GHatungimana EBazil AProzesky HNgassam EHuong TAyinkamiye NMoonde FNguyen QNNdyanabo AIbrahim MGani YMProssy NNunda EAchieng MNimkar SMtemang'ombe EAlthoff KDitangco RMukankubana JKazyoba PBereng MEgger MSipambo NNguyen PHNiyongabo ADiafouka MKunzekwenyika CNtombela SMwiine BBoniface KJuma LZHan ALaw MBryant MNalugoda FThng CKisaka VNyaga CLiotlo MNassolo RCoutinho CLuu MGaikwad SOloo LLelo PSohn AHKibet BRutto TCMukashyaka Sde AIWatson KMalika KSibweche RKibet HDiero LWongvoranet CDoan TTDuong VLyamuya RAzwa IIskandar SNg RXMayo BTeague REsteves JFerdous ZMukarwego VAbwao WONuket KWools-Kaloustian KShearer KKariminia AIeDEA global consortiumNguyen LTMayor ARafael INguyen LVKusemerewa PMatutu PFreeman ALoy DDavies MAKim JHKumarasamy NGroote PVLuque MTJalil EMayer CKoncwana CSanaso SSsemakadde MYonaba CPhuphuakrat ANiyibizi SSukmawati NLelo PVMDelewa MObuya MPasternak JSmith GMutenyo PTanoh EMukashyaka EMurto MBasri SKipsang CNg OTNdala ACMKurniati NAkele CNtarambirwa FNyiraneza MLChabala HMuula GKouadio KZannou MKimelil JJAbdulrasheed ETMachado DMKouadio SNahimana TSsenyonga HPefura EWKiptoo HMusaninyange JKambua PAchdiat PYunihastuti EFerreira FGFPetoumenos KDevote GKitahata MArusei LLoutfy MTossa LBMusaazi JHall SMave VHabiyaremye WShapiro JCrabtree-Ramirez BMalateste KGarton LMLeroy VRotich RDongen NVNiyigobaka TShyaka CMuleebwa JJiamsakul AKelly RYiannoutsos CKakvugu PWidhani ANiyonkuru OVera Veyieeneneng DAKosgei NNalwanga SSenoga JPChow ENiyonzima JAMcMahon JNjofu DSCastilho JLMbonze NGataha LKwong TSIngabire GKombela SOcasio KBorse RQuarter KPAmbula FJelagat JBanholzer NSomia ICoulibaly YAFolquet AUwakijijwe BGanu VThompson KGill JGatanaga HDame JATuyishimire YNyanzi BJNguyen DTSylvie NMHuwa JNizigiyimana AShah NSWu PCNyiransabimana SLAjaara AOmalla BAyihounton GBenn SKazigamwa EAHorberg MOuma PUtama MSCissy NMukakarangwa JDNansera DVarela DNakamanya ESowden DPujari SNorah KCele BCossy NKosgei AKMukahirwa OPraparattanapan JCyuzuzo MALMationg MLMabou GNamae ARouzier VNabagirinya SMoore RRamajaya IBKwitonda RIgizeneza ETempleton DJMessou EGayatri ACahn FPepela DTNdakalu LJacques NEley BColasanti JOchieng FTuyisenge LDuda SMuktiarti DMujawimana EUwimana BSeruyange EBunani GNalutaaya BDonozio KMaqhai MAggrey IGBenekigeri CHabimana VWicaksana BClaire KChan SMutuku NMIgirimbabazi JOAkoth CBorosio JDavid ANRupasinghe DAmonde VANash DBrenda KNyaboke DChongo GDjimon ZMRuengpanyathip CMaruri FMalata GEphrem MWisaksana RNsame DOdero SLee MPScovia NHitimana CCastrejon JMEuvrard JBrazier EWati DKRoth NLuzimbu GEldredge ABagamboula NTWezonga VKenyata RSangwa INancy SUmugwaneza MRFerreira TChebor VMisnan NAUmugiraneza FNdamijimana EAkama AMNzabahimana ENgauv BNyendikuu NGiang TLaurelle BKiertiburanakul SLainsi JNKirui WDzudie AYen NHabanabashaka JCIngabire MGManiragaba PVedaswari DHerrera IMurerwanimana ANamiso SNalubega RAlosa LNayiga IPrice SNayiga JHaburemyi VJean-Paul NRoss JLFink VCheptoo SAllen NGareta DCardoso SWSsekyeru ENantale PLwali JMusick BPexos CVelazquez LMichael DMakamba EKEkemesi RFilumba DMFon PMaritim HOdhiambo SRobert OAbiyasali ZBurton LOduori GWCisera KBirgen MChaiwarith RPinto JAPrasad HQhobela TChavez MPinto JKomena ENdlovu ZRobert KUwamahoro OFeza RRosemary NKoizumi YLaw MGKeza CBamford LHawkes ANafula NGunathilake MUemura HMercy NMurutu JWilliam Wester CJuliet NChimbetete CShapi LObatsa SThethe MMGahunzire FKorman TMugwaneza FJoshi KLimlertchareonwanit JNguyen NAyieko MFuhrer JDdungu ANguyen LWendrow AChoi JYHoy JNguyen DApaka CGolub JEAvihingsanon ANiyoyita DfalseThe implementation of tuberculosis preventive therapy in HIV care clinics in Africa, Asia and Latin America: a multiregional site survey.<h4>Introduction</h4>Towards the 'End TB Strategy' targets, the WHO recommends the provision of tuberculosis (TB) preventive therapy (TPT) for high-risk groups including people living with HIV (PLWH). 3 years after the release of the updated 2020 WHO guidelines, we investigated the implementation of TPT services at HIV clinics in low-income and middle-income countries (LMICs), focusing on TB screening, populations eligible for TPT and available TPT regimens.<h4>Methods</h4>In 2023, we surveyed HIV care clinics in the International Epidemiology Databases to Evaluate AIDS consortium in Africa, the Asia-Pacific and Latin America and the Caribbean. We used descriptive statistics to summarise TPT implementation according to WHO guidelines and multivariable logistic regression models to estimate associations with clinic characteristics.<h4>Results</h4>Of 172 HIV clinics included, 142 (83%) were in Africa, 22 (13%) in the Asia-Pacific and 8 (5%) in Latin America; 108 (63%) were located in urban areas. After ruling out active TB, TPT was reportedly offered to PLWH (122 clinics, 71%), household contacts of individuals with active TB (120 clinics, 70%) and other high-risk populations. TPT for PLWH was more frequently available in clinics in lower-income and low-middle-income countries, in high TB burden countries, and in district hospitals compared with other facility types. Clinics reported use of isoniazid-based (160 clinics, 93%) and shorter rifamycin-based (129 clinics, 75%) TPT regimens. Reported barriers to TPT initiation included patient refusal at 71 (41%) and drug shortages at 67 (39%) clinics.<h4>Conclusions</h4>TPT was available at most HIV care clinics in LMICs but further efforts are needed to reinforce WHO recommendations and ensure that TPT is consistently accessible to people at higher risk of developing active TB, especially PLWH.2026-01-01T00:00:00Z2026 Jan2026-06-14T06:01:54.272Z2026-06-14T03:16:48.552ZS-EPMC128535084159290910.1136/bmjgh-2024-018469