Physician adherence to isoniazid preventive therapy guidelines for HIV-infected patients in Thailand.

Isoniazid preventive therapy (IPT) has been shown to reduce the risk of active tuberculosis in tuberculin skin test (TST) positive human immunodeficiency virus (HIV) infected individuals. The World Health Organization has recommended IPT for HIV-infected patients since 1999. Physicians' non-adherence to the IPT guideline is one of the limitations to the wide spread use of IPT. A study of the extent to which physicians in Thailand adhere to this guideline will optimize the implementation of national IPT program. Three hundred physicians who provided medical care for HIV-infected patients were sampled by multistage cluster sampling of public hospitals according to the region and the level of health care service. Fifty-eight (19.3%) of the surveyed physicians provided IPT; 86.2% and 34.5% of physicians who provided IPT did not do the TST or screening chest radiography for active TB, respectively. Experience with HIV patient care was significantly associated with providing IPT.