Provider barriers, enablers, and incentives associated with the use of isoniazid preventive therapy among HIV-infected individuals in Ethiopia

Abstract

Isoniazid preventive therapy (IPT) is given to patients with latent infection of tuberculosis (TB) to prevent the progression to active disease. The World Health Organization (WHO) recommends six to nine months of IPT as part of the essential package of care for people living with HIV (PLHIV), in whom active TB is safely excluded. Despite evidence underscoring the importance of IPT in reducing HIV associated morbidity and mortality, IPT coverage of PLHIV remains low in most high burden TB/HIV settings, including Ethiopia. There is little empirical research examining why this policy has failed to become practice among providers and no clear strategy exists for addressing low IPT rates in Ethiopia. The objective of this study is to examine the barriers, enablers, and incentives that clinicians face in using IPT among their HIV patients across Ethiopia, and to identify areas of intervention.