Related Experiment Video

Updated: Mar 13, 2026

An Affordable HIV-1 Drug Resistance Monitoring Method for Resource Limited Settings

An Affordable HIV-1 Drug Resistance Monitoring Method for Resource Limited Settings

Published on: March 30, 2014

Differentiated HIV Service Delivery vs Conventional Care: Tuberculosis Preventive Therapy Outcomes for People Living

Ann Johnson^1,2, Lucy Chimoyi³, Salome Charalambous^3,4

¹Yale School of Medicine, New Haven, CT.

Journal of Acquired Immune Deficiency Syndromes (1999)

|March 11, 2026

Abstract

Introduction:

Differentiated service delivery (DSD) models, which reduce provider visits and offer varied ART delivery methods for people with HIV, are expanding across sub-Saharan Africa. However, their impact on services beyond ART, including the uptake and completion of tuberculosis preventive therapy (TPT), remains unclear.

Methods:

Using the RE-AIM framework, we analyzed data from Opt4TPT, a longitudinal cohort study examining TPT delivery in South Africa and Zimbabwe. We constructed multivariate logistic regression models to evaluate the association of receiving ART from a DSD model with TPT initiation and completion, as measured by electronic medication boxes. We constructed a Cox proportional hazards model to assess time to TPT initiation.

Results:

Among 1193 participants, 276 received ART through a DSD model, while 917 used the conventional model. Overall, 1035 (87%) initiated TPT, including 242 (88%) in DSD models and 793 (86%) in conventional models. Receiving ART from a DSD model was not significantly associated (OR 1.11, 95% CI: 0.74 to 1.67, P = 0.61) with TPT initiation. DSD models had a significantly longer mean time to initiation (6.5 vs. 2.7 days, P = 0.01). Among 731 (71%) with MERM box data, 356 (49%) completed TPT. Bivariate analysis showed higher odds of completing TPT among those in DSD models (OR 1.53, 95% CI: 1.06 to 2.21, P = 0.024), but this was not significant after adjusting for demographic and clinical factors (OR 0.89, 95% CI: 0.58 to 1.36, P = 0.58).

Conclusions:

High TPT uptake in DSD and conventional models indicate TPT delivery in DSD models is feasible. TPT completion was low in both models of care, showing a need to focus on improving TPT completion overall.

Keywords:

HIV differentiated service delivery sub-Saharan Africa tuberculosis preventive therapy

More Related Videos

An Automated Culture System for Use in Preclinical Testing of Host-Directed Therapies for Tuberculosis

An Automated Culture System for Use in Preclinical Testing of Host-Directed Therapies for Tuberculosis

Published on: August 16, 2021

Comprehensive & Cost Effective Laboratory Monitoring of HIV/AIDS: an African Role Model

Comprehensive & Cost Effective Laboratory Monitoring of HIV/AIDS: an African Role Model

Published on: October 31, 2010

Related Concept Videos

Pulmonary Tuberculosis V

Pulmonary Tuberculosis V

Medical management of tuberculosis (TB) patients involves a comprehensive approach that includes diagnosis, treatment, and monitoring. The specific strategies can vary depending on the type of tuberculosis (latent or active), the patient's overall health status, and other considerations.
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the...

Pulmonary Tuberculosis I

Pulmonary Tuberculosis I

Tuberculosis, often called TB, is a contagious illness primarily caused by Mycobacterium tuberculosis. It mainly affects the lung parenchyma but can also impact other body parts.
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...

Pulmonary Tuberculosis IV

Pulmonary Tuberculosis IV

Tuberculosis, more commonly referred to as TB, is an infectious disease stemming from Mycobacterium tuberculosis. While it primarily impacts the lungs, TB can also affect other body areas. Given its severity and global impact, timely and accurate diagnosis is crucial for controlling its spread and improving patient outcomes.
Several diagnostic approaches are used to detect TB. The conventional method is the Tuberculin Skin Test (TST), also known as the Mantoux test. However, this method has...

Pulmonary Tuberculosis II

Pulmonary Tuberculosis II

Tuberculosis, or TB, is a bacterial infectious disease caused by Mycobacterium tuberculosis. While its primary impact is on the lungs, leading to pulmonary tuberculosis, it can also affect various other organs, a condition referred to as extrapulmonary tuberculosis.
Here is a detailed explanation of its pathophysiology:
Transmission: The process begins when a person inhales droplet nuclei containing M. tuberculosis. These are typically released into the air when an individual with pulmonary or...

Pulmonary Tuberculosis III

Pulmonary Tuberculosis III

Tuberculosis (TB) is a contagious infection primarily affecting the lung parenchyma but which can also affect other body parts. TB can be classified based on disease development, presentation, and the affected anatomical site.
The first classification is based on the development of the disease, and it includes the following categories:

Retrovirus Life Cycles

Retrovirus Life Cycles

Retroviruses have a single-stranded RNA genome that undergoes a special form of replication. Once the retrovirus has entered the host cell, an enzyme called reverse transcriptase synthesizes double-stranded DNA from the retroviral RNA genome. This DNA copy of the genome is then integrated into the host’s genome inside the nucleus via an enzyme called integrase. Consequently, the retroviral genome is transcribed into RNA whenever the host’s genome is transcribed, allowing the...

Articles linked to this work by shared authors, journal, and citation graph.

Evaluating the acceptability, feasibility, and implementation fidelity of a multipurpose mobile health (mHealth) app used for Tuberculosis (TB) contact tracing by Ward-Based Outreach Teams (WBOTs) in South Africa.

PLOS global public health·2026

Mapping the research, policy, and clinical management landscape of post-tuberculosis lung disease: A scoping review.

PLOS global public health·2026

Targeted transcriptomic analyses of tuberculosis treatment response and outcomes in The Gambia.

Frontiers in tuberculosis·2026

Guiding principles for pragmatic randomised trials of tuberculosis treatments.

The Lancet. Infectious diseases·2026

Diagnostic accuracy and acceptability of self- and health worker-collected tongue swabs for Mycobacterium tuberculosis complex detection in adults in South Africa.

medRxiv : the preprint server for health sciences·2026

'Why should I start medication when I am not feeling sick?' A qualitative study of refusal, initiation, completion and discontinuation of tuberculosis preventive treatment among people living with HIV in sub-Saharan Africa.

BMJ public health·2026

See all related articles