Top 5 Takeaways

1. Significant Scale-Up in TB Preventive Treatment: From October 2016 to October 2023, about 13 million ART clients completed Tuberculosis Preventive Treatment (TPT) across 36 countries supported by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR).
2. High Completion and Initiation Rates: TPT completion rates have reached up to 87%, while initiation rates among ART-naive clients (those on ART for less than 6 months) peaked at 59%.
3. Continued Public Health Effort Needed: To maximize TPT coverage, especially among ART-naive clients, employing short-course regimens, patient-centered care, and improved medical record systems are recommended.
4. PEPFAR’s Commitment: Since 2018, PEPFAR has committed to offering TPT to all eligible clients on ART, marking a substantial push towards integrating TPT into the standard HIV care.
5. Impact and Further Steps: Despite achieving significant milestones, there is a need for more widespread adoption of shorter regimens, patient-centered approaches, and electronic medical record systems to ensure full TPT coverage.

Original Article Author and Citation

Corresponding Author

Stephanie O’Connor, ovi6@cdc.gov

Suggested Citation

Ajiboye AS, O’Connor S, Smith JP, et al. Tuberculosis Preventive Treatment Update — U.S. President’s Emergency Plan for AIDS Relief, 36 Countries, 2016–2023. MMWR Morb Mortal Wkly Rep 2024;73:233–238. DOI: [http://dx.doi.org/10.15585/mmwr.mm7311a1](http://dx.doi.org/10.15585/mmwr.mm7311a1).

Summary

The report details the progress in the integration of Tuberculosis Preventive Treatment (TPT) as part of the standard care for persons with HIV under the PEPFAR program across 36 countries. It emphasizes the substantial increase in TPT completion among ART clients, contributing to the global effort to reduce TB-related deaths among persons with HIV.

Methods

Data were collected from PEPFAR-supported programs, focusing on TPT initiation and completion rates among ART clients. The analysis included data disaggregated by age, sex, and HIV treatment status to assess trends in TPT coverage from 2016 to 2023.

Discussion

The steady increase in TPT completion rates highlights improvements in service delivery, monitoring, and reporting practices. However, to ensure comprehensive TPT coverage, there is an ongoing need to support all ART-naive clients through accessible and complete treatment courses, alongside adopting modern medical record systems and patient-centered care approaches.

Conclusion

PEPFAR’s commitment to TPT has significantly enhanced the integration of TB prevention into HIV care. To further improve TPT coverage and impact, expanding access to short-course regimens and developing patient-centric care models are essential steps. Analyzing the population-level impact of TPT on TB incidence and mortality will be crucial for future public health strategies.

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