Implementing TB preventive treatment within differentiated HIV service delivery models in global programs.

Area of Science:

• Public Health
• Infectious Disease Management
• HIV/AIDS Research

Background:

• Global initiatives aim to provide tuberculosis preventive treatment (TPT) to all eligible people living with HIV (PLHIV) on antiretroviral treatment (ART).
• Differentiated service delivery (DSD) models are increasingly used for person-centered HIV care, involving less frequent clinical visits for stable PLHIV.
• A potential gap exists in TPT delivery within DSD models, necessitating adaptations for seamless integration.

Purpose of the Study:

• To explore necessary adaptations for delivering TPT within differentiated service delivery (DSD) models for people living with HIV (PLHIV).
• To address the misalignment between traditional TPT delivery and innovative DSD for HIV care.
• To provide conceptual examples for program managers to operationalize TPT within DSD.

Main Methods:

• The study discusses programmatic considerations and adaptations for TPT delivery in DSD settings.
• It highlights the need for aligning TPT and ART prescribing, monitoring, and dispensing.
• Conceptual examples are presented to guide operationalization.

Main Results:

• Integrating TPT into DSD requires adapting eligibility determination, initiation, and clinical management processes.
• Aligning the timing and location of TPT and ART services is crucial for successful implementation.
• Programmatic adaptations are essential to ensure PLHIV on ART receive TPT within DSD frameworks.

Conclusions:

• Successful TPT scale-up within HIV programs necessitates adapting delivery models to align with DSD principles.
• Operationalizing TPT in DSD requires careful planning regarding service integration and patient management.
• Adaptations in TPT delivery are key to achieving comprehensive HIV and TB preventive care for all eligible PLHIV.