IUATLD - North American Region, Chicago, IL. March 2001

Hirsch-Moverman Y, Daud A, Gee V, Nader N, Colson PW, El-Sadr W. Treatment Preferences And Attitudes Among Patients Screened For Latent TB Infection At Harlem

Introduction: Treatment of Latent Tuberculosis Infection (LTBI) has traditionally involved 6 - 12 mos of isoniazid (INH). Shorter course regimens (RIF/PZA for 2 mos) have recently been offered but involve more pills and potentially side effects. Little is known about patient preferences for these LTBI regimens.

Methods: We assessed patients' demographics, treatment preferences, and TB knowledge & attitudes in Harlem. The preferences portion included 6 factors relating to treatment preferences, a presentation of two treatment options for LTBI treatment, treatment preference and reason for it. The K&A section included 24 items testing knowledge, and 26 items examining attitudes.

Results: Of 69 patients, 81% were African-American, 9% Latino, 30% foreign-born, mean age of 38 years, 41% had a history of homelessness, 54% had completed high school, and 10% were previously treated for LTBI. Fifty five percent of patients preferred the short-course treatment. Those who preferred the longer treatment tended to highlight fewer side effects (55%) and fewer pills (39%), while those who preferred shorter-course regimens emphasized short duration (92%). There was no difference in the TB Knowledge scores between INH group (16.0) and RIF/PZA group (16.2). RIF/PZA group perceived LTBI treatment as a hassle (30% vs. 3%, p=0.008), and reported shunning medical care when feeling sick (29% vs. 10%, p=0.073).

Conclusions: Different patients emphasized various factors in their preference for LTBI regimen. Findings suggest that shorter-course regimen may be especially suited to those likely to default treatment.