Predictors of adherence to isoniazid preventive therapy in people living with HIV in Ethiopia.

Abstract

Although isoniazid preventive therapy (IPT) is effective in the prevention of tuberculosis (TB) in people living with the human immunodeficiency virus (PLHIV), patient adherence to this strategy is suboptimal. This prospective cohort study was conducted in the HIV/AIDS (acquired immune-deficiency syndrome) out-patient chronic care unit of Dilla University Hospital, Dilla, Ethiopia, from May 2014 to February 2015. Adherence was defined as completion of the 6-month course of treatment with 90% of pills taken, as measured by diary and pill count. Data were collected on potential predictors, including patients' demographic and clinical characteristics. Univariable and multivariable logistic regression models were fitted to identify independent predictors of adherence to IPT. Of 162 PLHIV included, 104 (64.2%) were adherent to IPT. In the final multivariable model, concomitant use of antiretroviral therapy (ART) and/or cotrimoxazole preventive therapy (CPT) was associated with adherence to IPT (OR 2.66, 95%CI 1.15-6.17). Experiencing a high level of HIV stigma and episodes of opportunistic infections tended to be associated with non-adherence to IPT (OR 0.51, 95%CI 0.25-1.04 and OR 0.14, 95%CI 0.02-1.15) in comparison to low stigma and no opportunistic infections, respectively. PLHIV receiving ART or CPT were more likely to adhere to IPT.