Isoniazid Preventive Therapy Adherence and Its Predictors Among Soldiers on HIV Antiretroviral Therapy at a General Military Hospital in Uganda.

Abstract

Background: Uganda faces a significant dual challenge with tuberculosis (TB), ranking among these countries most affected by the disease worldwide. The World Health Organization (WHO) recommends isoniazid preventive therapy (IPT) for managing latent TB. However, the adherence to IPT in military settings remains under-explored in Uganda. This study aims to assess IPT adherence and identify its predictors among soldiers undergoing HIV antiretroviral therapy at a General Military Hospital in Uganda.

Methodology: We conducted a cross-sectional study involving 300 HIV-positive soldiers receiving antiretroviral therapy (ART) at the General Military Hospital in Uganda. Due to the small sample size, we employed a consecutive sampling method. We utilized descriptive statistics and modified Poisson regression model for prevalence of IPT adherence and associated factors respectively.

Results: Among the 300 clients, the prevalence of isoniazid preventive therapy (IPT) was 94.7%, 95% CI: 92.1-97.2; adherence to IPT was associated with being aged ≥ 50 years, with a prevalence ratio (PR) of 1.061 and 95% CI: 1.01-1.12; being married, with a PR of 1.438, 95% CI:1.12-1.84; having social support, with a PR of 1.498, 95% CI:1.17-1.92; and having social support played a significant role in IPT adherence among married participants, with a PR of 0.817,95% CI:0.72-0.93.

Conclusion: To enhance adherence to isoniazid preventive therapy among young soldiers with HIV, targeted interventions are crucial, as older individuals tend to adhere better. Implementing marital support programs and strengthening community engagement can bolster adherence through social support networks. Educational campaigns should focus on the importance of IPT, while regular follow-ups will ensure effective monitoring and support. Further research is needed to explore how social support can mitigate stigma associated with HIV. The findings highlight the importance of improving IPT adherence among married soldiers and suggest that this approach could be effective in other low-resource settings.