Adherence to isoniazid and rifapentine preventive therapy for better treatment outcomes among adults living with HIV in public health facilities in Addis Ababa: a multicenter study

Abstract

Tuberculosis (TB) remains a serious public health problem among people living with HIV (PLHIV), and preventive measure is therefore essential. To scale up TB prevention, Ethiopia has rolled out a preventive regimen consisting of isoniazid and rifapentine taken once weekly for three months (3HP). In spite of its paramount importance, limited evidence exists on adherence to this regimen among adults living with HIV in Addis Ababa. Therefore, this study assessed adherence to 3HP and factors influencing it among PLHIV receiving care in public health facilities. A facility-based cross-sectional study was conducted from July 20 to September 3, 2023, among 375 PLHIV receiving 3HP in selected public health facilities in Addis Ababa. Participants were enrolled using systematic sampling. Data were collected using interviewer-administered questionnaires and patient records. Multivariable logistic regression analysis was performed to identify factors associated with adherence. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) were reported, and statistical significance was set at p < 0.05. Overall, adherence to 3HP therapy was 92.5% (95% CI: 89.42–94.78%). Non-substance use was positively associated with 3HP adherence (AOR = 2.74; 95% CI: 1.19–5.54). While, ART discontinuation (AOR = 0.14, 95% CI: 0.06–0.34), long waiting times (AOR = 0.22, 95% CI: 0.1–0.50), and reported 3HP-related side effects (AOR = 0.08; 95% CI: 0.01–0.42) were negatively associated with 3HP adherence. Adherence to 3HP preventive therapy among adults living with HIV in Addis Ababa was relatively high. Strengthening counseling for substance users, supporting ART adherence, and improving service efficiency may further enhance adherence.