11th International AIDS Conference Vancouver, British Columbia — July 7-12, 1996

Int Conf AIDS 1996 Jul 7-12; 11:34 (abstract no. LB.C.6063)
Natpratan C, Akrasewi P, Kongsin S, Prapanwong A; Office of Communicable Disease Control Region 10, Chiang-Mai, Thailand. Fax: 66-53-271020.

OBJECTIVE: TB is a common opportunistic infection among HIV/AIDS patients in northern Thailand. The seroprevalence of HIV in TB patients increased from 5.2% in 1989 to 40% in 1995. HIV-associated TB has high morbidity and mortality. We studied demand for preventive therapy, compliance, and completion of a preventive therapy regimen, costs, and sustainability of the program.

METHODS: IPT has been conducted in 5 HIV/AIDS Counseling and Testing sites (ACTs). TB education was provided to clients during pre-test and post-test counseling. HIV positive clients were offered TB preventive therapy after TB education and counseling. Participation is voluntary. After consent, participants were screened for active tuberculosis by history, clinical exam, Chest X-rays and Sputum examination (if indicated). Recruitment criteria are: No active TB, No active OI's disease(s), No history of liver disease or allergy to INH, residence in an accessible area. Isoniazid (INH) was given at daily dose 300 mg with 10 mg of B6.

RESULTS: 416 HIV-infected were screened and recruited, mean age of 30.6 years. There were 192 males and 224 females, 6 (1.5%) quit the program after recruitment, 4 developed rash and subsequently chose to quit. 22 (5.3%) absconded from the program and 31 died from other causes presumably unrelated to TB. 5 (1.4%) left the study area. 49 (28%) completed a 9 month cause of chemotherapy. 299 are in active follow up. None were reported having tuberculosis. An extrapolation of these results is that 77% complete chemotherapy. In-depth interviews of Health Care Workers (HCWs) and subjects offered insights into qualitative data. Good counseling, compassionate and friendly service, TB education, HIV self acceptance, non-discrimination, and family support were positive factors; living alone, being single, denial attitude, lack of peer or family support were negative factors.

CONCLUSIONS: Preventive TB chemotherapy may be a useful method to prevent TB in areas with high prevalence of TB and HIV infection. The Program gave a "Sense of Hope" for many participants. However, feasibility of the program depends largely on health infrastructure, quality counseling services, family and peer support, and patient's attitude toward AIDS.

960707
LBC6063

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