Health education guide for promotion of understanding and use of isoniazid preventative therapy uptake amongst HIV positive patients

Abstract

PURPOSE: The purpose of this study was to develop a health education guide to promote understanding and use of Isoniazid preventive therapy amongst HIV positive patients to decrease tuberculosis burden in HIV patients. DESIGN: This study used explanatory sequential mixed methods; quantitative data collection and analysis followed by qualitative data collection and analysis. METHODS: The quantitative phase was followed by data collection and analysis of the qualitative phase. Structured and semi-structured interview guide questionnaires were used to collect both quantitative and qualitative data. A total of 252 patients and 12 health care providers enrolled in quantitative and qualitative study respectively. Simple random sampling method was used for quantitative study. Descriptive statistics was used, and percentages were calculated. Bivariate and multivariate logistic regressions were applied to identify associations between variables. In subsequent qualitative section of the study, health care providers were interviewed. Qualitative data was organized in themes and analysis was done manually. RESULTS: Quantitative and qualitative data was analyzed subsequently. Of the 252 study participants, 56.7% of the participants were provided with tuberculosis preventive therapy. However, only 43.3% completed the prescribed treatment within the specified period. In logistic regression analysis, participants’ gender (P=0.032), residence (P=0.020), viral load suppression status (P=0.037), awareness and information on IPT benefit (P=0.000), awareness on IPT reduce the occurrence of tuberculosis (P=0.017), was found significantly associated with IPT acceptance. In addition, in an indepth interview of health care providers: patient’s refusal, non completion, inadequate providers counseling and patient education practices, misconceptions and misunderstandings of patients about IPT, fear of drug resistance, pill burden and drug side effect, lack of training and education guide were identified barriers for IPT implementation. CONCLUSION: Uptake of isoniazid preventive therapy in PLHIV in a tertiary hospital is sub-optimal and the completion rate among initiated IPT was found low. Intervention focused on initiation as well as completion of IPT needed. Consequently Health education guide developed to improve IPT uptake; client focused individual counseling; BCC and the need for initiation of short term TPT regimens were recommended.