Tuberculosis Preventive Therapy among Persons Living with HIV, Uganda, 2016–2022

T uberculosis (TB) is the leading cause of illness and death globally among persons living with HIV (PLHIV) (1,2).In 2021, among ≈38.4 million PL-HIV worldwide, 703,000 TB cases and 187,000 TBrelated deaths were reported (3,4).HIV antiretroviral therapy (ART) and TB preventive therapy (TPT) reduce TB incidence and death among PLHIV (5,6).TPT is administered to persons at high risk for TB and who do not have symptoms of active disease; positive tuberculin skin tests or interferon gamma release assays are not required.Although increased ART coverage has coincided with declines in TB-related deaths worldwide, since the early 2000s, TPT scale-up has been limited (3,7,8).Uganda is a World Health Organization-designated TB and HIV high-burden country (3).By 2020, ≈1,400,000 PLHIV were reported in Uganda; in 2021, a total of 29,000 TB cases and 6,200 TB-related deaths among PLHIV were reported (9,10).In 2015, Uganda accelerated efforts to provide TPT to PLHIV who had no TB symptoms and received support from the US President's Emergency Plan for AIDS Relief (PEPFAR) (11,12).Further efforts included a 100-day scale-up campaign in 2019, adopting TPT as standard of care for all eligible PLHIV in 2021 (13), and a last-mile campaign launched in June 2022.Therefore, despite the COVID-19 pandemic, TPT scale-up continued.We analyzed data describing TPT scaleup among PLHIV in Uganda and highlight next steps to further reduce TB-related illness and death and reach global targets for treatment coverage. The StudyWe sourced semiannual aggregate data during October 2016-March 2022 from the centralized PEP-FAR DATIM Monitoring, Evaluation, and Reporting database (Uganda DATIM version 1.31 MER 2.5, updated January 4, 2021; https://ug.datim4u.org).We analyzed trends among PLHIV receiving PEPFAR-supported ART across 5 areas: TPT initiation, defined as beginning any TPT regimen, such as 6-month daily isoniazid or 3-month 1 time/week isoniazid plus rifapentine; TPT completion, defined as receiving a full course of TPT according to data capture tools; TPT completion rates, calculated as the number of TPT completions divided by the number of TPT initiations in the previous semiannual period × 100; TPT coverage, calculated as the number of TPT completions divided by the total number of PLHIV eligible for TPT; and TB notification among PLHIV on ART, calculated as the number of registered new and relapsed TB patients with documented HIV-positive status divided by the total number of PLHIV on ART.TPT eligibility was defined as 95% of total PLHIV on ART; TPT ineligibility (5%) accounts for PLHIV with active TB and PLHIV Tuberculosis Preventive Therapy among Persons Living with HIV, Uganda, 2016-2022