Isoniazid Preventive Therapy Adherence among Soldiers on HIV Antiretroviral Therapy at a General Military Hospital in Uganda

Abstract Uganda has a heavy double burden of tuberculosis (TB) and currently ranks among the seven 9 highest TB-affected countries globally. The World Health Organization (WHO) recommends 10 isoniazid preventive therapy (IPT) for treating latent TB. However, the adherence to IPT in 11 military settings has not been well documented in Uganda. 12 We conducted a cross-sectional study among 300 HIV-positive patients receiving 13 antiretroviral therapy (ART) at the General Military Hospital in Uganda. The Consecutive 14 sampling method was used to select clients and a modified Poisson regression model of 15 family Poisson and link log with robust standard errors to adjust for overinflated variances 16 was used for analysis. Among the 300 clients, the prevalence of IPT was 94.7%, 95% CI: 92.1-97.2; adherence to 18 IPT was associated with being aged ≥ 50 years, with a prevalence ratio (PR) of 1.061 and 19 95% CI: 1.01-1.12; being married, with a PR of 1.438, 95% CI:1.12-1.84; having social 20 support, with a PR of 1.498, 95% CI: 1.17-1.92; and having social support played a significant 21 role in IPT adherence among married participants, with a PR of 0.817, 95% CI: 0.72-0.93. 22 There is a need for strategies to improve access to, retention of and adherence to IPT for 23 young soldiers. Additionally, advocating for social support and behavioural interventions is recognized as a crucial requirement for improving IPT adherence among soldiers living with 25 HIV. More research is needed to explore the role of social support in reducing the social 26 stigma associated with HIV-positive individuals. The findings from this study suggest a 27 necessity to boost IPT adherence among married participants living with HIV, and the model 28 could be applied in other resource-constrained and low-middle-income countries.