Zürcher, KathrinCox, Samyra R.Ballif, MarieEnane, Leslie A.Marcy, OlivierYotebieng, MarcelReubenson, GaryImsanguan, WoraratOtero, LarissaSuryavanshi, NishiDuda, Stephany N.Egger, MatthiasTornheim, Jeffrey A.Fenner, LukasInternational Epidemiology Databases to Evaluate AIDS (IeDEA)2023-02-282023-02-282022-03Zürcher, K., Cox, S. R., Ballif, M., Enane, L. A., Marcy, O., Yotebieng, M., Reubenson, G., Imsanguan, W., Otero, L., Suryavanshi, N., Duda, S. N., Egger, M., Tornheim, J. A., Fenner, L., & AIDS (IeDEA), I. E. D. to E. (2022). Integrating services for HIV and multidrug-resistant tuberculosis: A global cross-sectional survey among ART clinics in low- and middle-income countries. PLOS Global Public Health, 2(3), e0000180. https://doi.org/10.1371/journal.pgph.0000180https://hdl.handle.net/1805/31527Tuberculosis (TB) is the leading cause of death among PLHIV and multidrug-resistant-TB (MDR-TB) is associated with high mortality. We examined the management for adult PLHIV coinfected with MDR-TB at ART clinics in lower income countries. Between 2019 and 2020, we conducted a cross-sectional survey at 29 ART clinics in high TB burden countries within the global IeDEA network. We used structured questionnaires to collect clinic-level data on the TB and HIV services and the availability of diagnostic tools and treatment for MDR-TB. Of 29 ART clinics, 25 (86%) were in urban areas and 19 (66%) were tertiary care clinics. Integrated HIV-TB services were reported at 25 (86%) ART clinics for pan-susceptible TB, and 14 (48%) clinics reported full MDR-TB services on-site, i.e. drug susceptibility testing [DST] and MDR-TB treatment. Some form of DST was available on-site at 22 (76%) clinics, while the remainder referred testing off-site. On-site DST for second-line drugs was available at 9 (31%) clinics. MDR-TB treatment was delivered on-site at 15 (52%) clinics, with 10 individualizing treatment based on DST results and five using standardized regimens alone. Bedaquiline was routinely available at 5 (17%) clinics and delamanid at 3 (10%) clinics. Although most ART clinics reported having integrated HIV and TB services, few had fully integrated MDR-TB services. There is a continued need for increased access to diagnostic and treatment options for MDR-TB patients and better integration of MDR-TB services into the HIV care continuum.enAttribution 4.0 Internationalmulti-drug-resistant tuberculosisHIVantiretroviral therapyArticle