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

Abstract: Background: Uganda 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. Methods: We 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. Results: Of 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. Conclusion: There 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 behavioral 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. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement Research reported in this publication was supported by the Fogarty International Centre, National Institute on Mental Health of the National Institutes of Health under Award Number D43TWO10037. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Health. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: This study was approved by the School of Medicine Research and Ethics committee (SOMREC), Number 2022- 401. All participants gave informed consent to participant in the study. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All the data produced in this study is available upon reasonable request to the authors and contained in this manuscript