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Background: Tuberculosis remains a significant global health concern, especially for People Living with HIV, who are at an increased risk of severe TB disease. Despite the availability of TB Preventive Treatment, knowledge gaps persist among People Living with HIV regarding its importance, accessibility, and administration. The study aimed to assess TPT knowledge levels and determinants among People Living with HIV in Tanzania. Methods: A cross-sectional survey was conducted from April to May 2023 in 12 regions of mainland Tanzania. The study included PLHIV aged 18 years and above, receiving HIV care in selected Care and Treatment Centers. Data were collected through face-to-face interviews using a semi-structured questionnaire covering sociodemographic characteristics and Tuberculosis preventive treatment knowledge. Descriptive statistics, chi-square tests, and logistic regression analyses were employed for data analysis. Results: Out of the 391 People Living with HIV interviewed, 71.4% demonstrated adequate Tuberculosis preventive treatment knowledge. Female participants, those attending urban health facilities, and individuals with longer durations of HIV care exhibited higher Tuberculosis preventive treatment knowledge levels. However, knowledge disparities persisted based on demographic characteristics such as gender and location of health facilities. Conclusion: While a considerable portion of People Living with HIV demonstrated adequate higher Tuberculosis preventive treatment knowledge, addressing gaps among those with lower understanding is crucial. Targeted education campaigns tailored to the needs of People Living with HIV, especially in rural areas and among male populations, are essential. Collaborative efforts between national health programs and community organizations are vital to integrate Tuberculosis preventive treatment awareness effectively into comprehensive HIV care programs, ultimately reducing the burden of Tuberculosis among People Living with HIV and the general population. [ABSTRACT FROM AUTHOR]

Introduction: Differentiated Service Delivery Models (DSDM), a strategy to promote retention in HIV care and/or ART adherence, is now increasingly recognized as an important and sustainable approach that could contribute significantly toward the UNAIDS 90-90-90 by 2020 and 95-95-95 by 2030 targets and ultimately an AIDS-free generation. This study was conducted to determine the outcomes of DSDM among people living with HIV in Tanzania. Methods: A Cross-sectional analytical design approach employing both quantitative and qualitative data collection methods was adopted in this study that was implemented in 9 regions of Tanzania. We conducted record reviews and in-depth interviews with key informants at national and facility levels where their data was summarized and arranged in sub-themes and then analyzed according to the specific objectives by using Thematic Analysis. We further conducted a bivariate analysis using Chi-Square to assess the association between each outcome and explanatory variable. Unadjusted and adjusted analysis was conducted to determine predictors of unfavourable outcomes using logistics regression models. Results: Data was collected from 50 health facilities comprising 15 (30.0%) hospitals, 22 (44.0%) health centres and 13 (26.0%) dispensaries. Record reviews were for different outcomes as follows; Mis-categorization (13,056 records), Missed appointments (62,222 records), Advanced HIV disease (29,995 records), and Attrition (62,222 records). Among the 320 unstable clients, the rate of miscategorization significantly decreased after the introduction of DSDM, from 63% to 36% (p < 0.001). After the introduction of DSDM, more clients missed their appointments compared to the period before the introduction of DSDM (1.7% vs 0.8% respectively). Missed appointments were associated with an urban setting ( AOR 1.1, 95% CI 1.1-1.2) and older age of 50 years and more (AOR 1.2, 95% CI 1.1-1.4) in comparison to a rural setting and younger age of fewer than 15 years respectively. Furthermore, DSDM led to a decrease (from 56% to 49%) of those with advanced WHO stage among the first-time testers. Attrition among the clients was higher after the introduction of DSDM compared to that before DSDM (ARR 1.1, 95% CI 1.04-1.2). Contributors to attrition were those related to individuals and institutions including beliefs in faith healing, fear of stigma and wrong interpretation of viral load monitoring results. Conclusion: Decentralized Community-based ART model is a promising entry point to improved HIV/AIDS service delivery. Strategies are needed to harmonise the comprehensiveness and quality of services across facilities providing HIV services. [ABSTRACT FROM AUTHOR]