Tuberculosis coinfected with HIV constitutes a large proportion of patients in Ethiopia. Isoniazid preventive therapy (IPT) is recommended for the treatment of latent tuberculosis infection. However, the level of IPT adherence and associated factors among people living with HIV (PLHIV) have not been well explored. This study aimed to assess adherence to IPT and associated factors among PLHIV in Addis Ababa. Facility based cross-sectional study was conducted. The study was conducted in 10 health centers and 2 hospitals. Patients were consecutively recruited till the required sample size was obtained. From 406 PLHIV approached, a total of 381 patients on IPT were interviewed. Data were entered and analyzed using Epi-Info version 3.5 and SPSS version 16. The level of adherence to IPT was 89.5%. Patients who have taken isoniazid for ≥5 months were more likely to be adherent than those who took it for 1-2 months [AOR (95%CI) = 5.09 (1.41–18.36)]. Patients whose friends decide for them to start IPT were less likely to be adherent than others [AOR (95%CI) = 0.10 (0.01–0.82)]. The level of adherence to IPT in PLHIV was high. Counseling of patients who are in their first two months of therapy should be more strengthened. Strong Information Education Communication is essential to further enhance adherence. 1. Introduction Globally, the number of people living with HIV (PLHIV) continues to grow. According to UNAIDS report, globally, an estimated 35.3 (32.2–38.8) million people were living with HIV and 1.6 (1.4–1.9) million AIDS related deaths in 2012. Sub-Saharan Africa continues to bear the burden of the global epidemic. A total of 25.0 (23.5–26.6) million people were living with HIV in 2012 in sub-Saharan Africa and an adult prevalence of 4.7% is reported [1–3]. With an estimated 1.1 million PLHIV, Ethiopia has one of the largest populations of HIV infected people in the world. However, HIV prevalence among the adult population is lower than many sub-Saharan African countries. The national and Addis Ababa adult HIV prevalence in 2010 was estimated to be 2.4% and 9.2%, respectively [4, 5]. TB though curable, it is one of the most common causes of HIV-related illness and death. About 11.5 million adults living with HIV/AIDS are estimated to be coinfected with Mycobacterium tuberculosis, with 71% of those coinfected living in sub-Saharan Africa. In Ethiopia, routine data from 44 sites in the year 2005/2006 showed that 41% of TB patients are HIV positive. Another routine data collected in 2006/2007 showed that coinfection is 31% [2, 6]. HIV is the most important
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