FIGURE 2.

TPT delivery for stable PLHIV in DSD: conceptual example of a facility-based model. PLHIV stable on ART are enrolled in a DSD model that consists of 3-month ART prescribing (fast-track medication pick-up and screening for presumptive TB, AEs, and adherence at the pharmacy) and 6-month clinic visits. When these PLHIV start TPT after appropriate TB screening and evaluation, as well as counseling on benefits of TPT and on potential TPT-related AEs using standardized education materials, a 1-month supply of TPT is given at their routine 6-month clinic visit. They return 1 month later for a TPT assessment (screening for presumptive TB, AEs, and adherence) at the facility. If no presumptive TB, serious AEs, or adherence concerns are identified, PLHIV are given a 2-month supply of TPT. They then return 2 months later for their regularly scheduled ART fast-track visit, where they undergo a TPT assessment by the pharmacist in addition to collecting 3 months of ART and TPT (if no presumptive TB, serious AEs, or adherence concerns are identified). At the next 6-month clinic visit, a TPT assessment and evaluation for completion is conducted by the clinician. This model has the following benefits: stable PLHIV on ART only ‘break’ their regular cycle of 6-month facility visits once, 1 month after initiating TPT. ART = antiretroviral therapy; TPT = TB preventive treatment; TB = tuberculosis; AE = adverse event; PLHIV = people living with HIV; DSD = differentiated service delivery.