“Now that I took TPT, it’s affecting my ART adherence, viral load, even my wellbeing in the community”. Exploring acceptability and experience of Tuberculosis Preventive Treatment among adolescents living with HIV in Zimbabwe
Bibliographic Data
| ID | 19592645 |
|---|---|
| Authors | Joni Lariat (0000-0003-1240-6916, The University of Sydney, corresponding author), Rufaro Mbundure (Centre for Sexual Health and HIV AIDS Research, corresponding author), Webster Mavhu (0000-0003-1881-4398, Liverpool School of Tropical Medicine, corresponding author), Abigail Mutsinze (0000-0003-0668-3343, corresponding author), Mikaela Coleman (0000-0002-4414-5645, The University of Sydney, corresponding author), Sharon Sibanda (0000-0002-6595-4097, Centre for Sexual Health and HIV AIDS Research, corresponding author), Pueshpa Shaba (Centre for Sexual Health and HIV AIDS Research, corresponding author), Laura Kafata (Centre for Sexual Health and HIV AIDS Research, corresponding author), Leviticus Makoni (0009-0005-0802-3092, Centre for Sexual Health and HIV AIDS Research, corresponding author), Ann Selberg (corresponding author), Carol Wogrin (0000-0001-9066-8845, corresponding author), Owen Mugurungi (0000-0001-7779-5583, Ministry of Health and Child Welfare, corresponding author), Charles Sandy (0000-0003-0264-7900, African Union, corresponding author), Nicola Willis (0000-0003-0452-0196, corresponding author), Bernay (0000-0001-7628-8408, The University of Sydney, corresponding author) |
| Editors | Hannah Hogan Leslie |
| Year | 2025 |
| Volume | 5 |
| Issue | 11 |
| Pages | e0005102 |
| Publication date | 2025-11-04 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | PLOS Global Public Health (JOURNAL) |
| Journal identifiers | ISSN: 2767-3375 • E-ISSN: 2767-3375 |
| Publisher | Public Library of Science (PLoS) (PUBLISHER) |
| DOI | 10.1371/journal.pgph.0005102 |
| PMID | 41187123 |
| OpenAlex | W4415885095 |
| Language | EN |
| References cited | 37 |
Tuberculosis preventive treatment (TPT) is increasingly offered to people living with HIV in high-burden settings, including adolescents and young people (AYPLHIV). Evidence demonstrates that AYPLHIVs’ HIV treatment engagement is improved by the provision of tailored support. How to effectively adapt this support to accommodate multimorbidity care, such as TPT alongside ART, warrants attention to deliver sustained optimal outcomes. We conducted qualitative research to better understand AYPLHIVs’ experiences when initiating TPT and their related support needs. Peer counsellors (18–24 years) who were offered TPT within routine HIV care participated in two focus groups (n = 16 participants) and in-depth interviews (n = 12) in Harare. Iterative data collection and thematic analysis was conducted September 2023 to February 2024. TPT was presented by healthcare workers as uncomplicated and routine. This contrasted with participants’ accounts of the significant disruptive and challenging experience of taking up TPT. This tension led many to stop TPT without support. Those who completed treatment were motivated by personal circumstances (e.g., recently witnessing severe TB illness, pregnancy); however, taking up and completing subsequent courses of TPT was not assured. TPT side effects and stigma led many to discontinue treatment, even when these were not personally experienced. Side effects recalled past experiences of HIV-stigma and discrimination, and undermined ART adherence, HIV viral suppression, and positive mental health. Introducing additional life-protecting treatments can have complicating biosocial effects, with consequences for individuals and public health. To support multimorbidity prevention and care, we outline five principles to guide initiating and maintaining treatment that acknowledges and responds to AYPLHIVs’ dynamic immunological and social realities: Supported and safe relationships; Tailored messaging; Adaptable support; Respect for agency and autonomy; Timing: plan, review, revise (START). START emphasises investing in consistent peer support throughout adolescence, and centring AYPLHIVs’ agency, embodied knowledge and wellbeing to ensure they are informed decision-makers about their health
Focus group · Health care · Mental health · Public health · Qualitative research · Social stigma · Thematic analysis · Adolescent Sexual and Reproductive Health · HIV/AIDS Research and Interventions · Tuberculosis Research and Epidemiology
Mental health challenges among adolescents living with HIV
Disability weights for the Global Burden of Disease 2013 study
Factors associated with low tuberculosis preventive therapy prescription rates among health care workers in rural South Africa
Mental health and other clinical and social characteristics of young mothers living with HIV in Zimbabwe
Embodiment and biographical disruption in people living with HIV/Aids (PLWHA)
Structural barriers to implementing recommended tuberculosis preventive treatment in primary care clinics in rural South Africa
I am not alone with tears”
Not Taking it Will Just be Like a Sin
| Highly cited | No |
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