Characteristics of PLHIV, CHWs, and TS.

Tanzania rolled-out a 12-dose, weekly regimen of isoniazid plus rifapentine (3HP) TB preventive treatment in January 2024. The 3HP completion rate is generally ≥80%, varying by delivery strategy and programmatic setting. Before the roll-out, a mixed methods study was conducted to assess whether a family approach involving family member support, SMS reminders, and three health education sessions was acceptable and optimized 3HP uptake and completion. This paper describes acceptability of the family approach among people living with HIV (PLHIV), treatment supporters (TS), and community health workers (CHWs). This was a qualitative descriptive study in 12 HIV care and treatment centers across six administrative regions. We purposively sampled 20 PLHIV, 12 CHWs for in-depth interviews, and 23 TS for three focus group discussions held between September and December 2023. The theoretical framework of acceptability guided thematic-content analysis using a framework approach. Participants understood that PLHIV have an increased risk for active TB and that 3HP provides shortened treatment for TB disease prevention. They learned about TB and 3HP through health education sessions, but participation of TS was low due to expensive transportation costs to clinics. Receiving support from a trusted person and SMS were perceived as good adherence reminders. The majority reported mild self-limiting side effects but expressed positive attitudes because of the shortened treatment, TB counseling, satisfaction from helping others, lifestyle and work alignment, and reduced work burden. Some PLHIV had difficulties identifying supportive family members, so they chose close friends or CHWs. The family approach to supporting 3HP adherence is widely accepted by PLHIVs, TS, and CHWs in the context of person-centered care that respects their preferences. We recommend its adoption in programmatic settings as a combined approach, considering changes made during the study. However, further research is warranted to assess its acceptance among other populations eligible for 3HP.坦桑尼亚于2024年1月正式推出异烟肼加利福喷汀（3HP）的12剂次周疗结核病预防性治疗方案。3HP的完成率通常不低于80%，具体数值因给药策略与项目实施场景而异。在该方案推广前，研究团队开展了一项混合方法研究，以评估包含家属支持、短信提醒及三次健康教育课程的家属参与模式是否具备可接受性，并能否优化3HP的参与度与完成率。本文旨在阐述艾滋病病毒感染者（PLHIV，People Living with HIV）、治疗支持者（TS）及社区卫生工作者（CHWs）对该家属参与模式的接受度。本研究为质性描述性研究，在覆盖6个行政区的12家艾滋病诊疗中心开展。研究于2023年9月至12月期间，采用目的性抽样法招募20名艾滋病病毒感染者、12名社区卫生工作者进行深入访谈，并招募23名治疗支持者开展3次焦点小组讨论。本研究以接受度理论框架为指导，采用框架分析法开展主题内容分析。参与者均明确知晓艾滋病病毒感染者罹患活动性结核病的风险更高，且3HP作为结核病预防性治疗方案的疗程更短。参与者通过健康教育课程了解了结核病与3HP的相关知识，但由于前往诊所的交通成本高昂，治疗支持者的参与度普遍较低。参与者认为，来自可信人员的支持与短信提醒均可作为有效的服药依从性提醒手段。多数参与者报告出现轻微的自限性不良反应，但仍对该方案持积极态度，其积极态度的成因包括疗程更短、结核病咨询服务、助人带来的满足感、与生活及工作节奏相适配，以及工作负担得以减轻。部分艾滋病病毒感染者难以找到愿意提供支持的家属，因此选择亲密好友或社区卫生工作者作为支持者。在尊重参与者偏好的个性化照护框架下，该用于提升3HP服药依从性的家属参与模式获得了艾滋病病毒感染者、治疗支持者及社区卫生工作者的广泛认可。结合本研究中发现的可优化方向，我们建议在项目实施场景中采用该联合模式。但未来仍需开展进一步研究，以评估该模式在其他符合3HP用药指征的人群中的接受度。