Authors: 

L Gunde, A Wang, D Payne, S O’Connor, A Kabaghe, N Kalata, A Maida, D Kayira, V Buie, L Tauzi, A Sankhani, A Thawani, E Rambiki, A Ahimbisibwe, T Maphosa, K Kudiabor, R Nyirenda, J Mpunga, K Mbendera, P Nyasulu, F Kayigamba, M Farahani, A C Voetsch, K Brown ², A Jahn, B Girma, K Mirkovic; MPHIA Survey Team

Abstract:

BACKGROUND: TB preventive treatment (TPT) reduces morbidity and mortality among people living with HIV (PLHIV). Despite the successful scale-up of TPT in Malawi, monitoring and evaluation have been suboptimal. We utilized the Malawi Population-Based HIV Impact Assessment (MPHIA) 2020‐2021 survey data to estimate TPT uptake and completion among self-reported HIVpositive persons.

METHODS: We estimated the proportion of HIV-positive respondents who had ever undergone TPT, and determined the percentage of those currently on TPT who had completed more than 6 months of treatment. Bivariate and multivariable logistic regression were performed to calculate the odds ratios for factors associated with evertaking TPT. All variables were self-reported, and the analysis was weighted and accounted for in the survey design.

RESULTS: Of the HIV+ respondents, 38.8% (95% CI 36.4‐41.3) had ever taken TPT. The adjusted odds of ever taking TPT were 8.0 and 5.2 times as high in the Central and Southern regions, respectively, compared to the Northern region; 1.9 times higher among those in the highest wealth quintile, and 2.1 times higher for those on antiretroviral therapy >10 years. Of those currently taking TPT, 56.2% completed >6 months of TPT.

CONCLUSION: These results suggest low TPT uptake and >6 months’ completion rates among self-reported HIV+ persons. Initiatives to create demand and strengthen adherence would improve TPT uptake.