1. Integration of HIV and TB services results in earlier and more prioritised ART initiation in Uganda. Sabine Hermans 1,2,3, Barbara Castelnuovo 1, Andrew Kambugu 1, Joep Lange 2, Andy Hoepelman 3, Yuka Manabe 1,4 1 Infectious Diseases Institute, Makerere University College of Health Sciences, Uganda 2 Department of Global Health, Academic Medical Center, University of Amsterdam, Amsterdam Institute for Global Health and Development, the Netherlands 3 Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht, the Netherlands 4 Johns Hopkins University School of Medicine, Baltimore, United States of America

2. Methods & Results Fewer ART naïve TB patients were initiated on ART in 2009 versus 2007 (56% and 66%, P=0.03), but this decrease was only in patients with higher CD4 counts. 20072009P-value Intensive phase (n, %)37 (23.0)78 (60.0) Continuation phase (n, %)88 (54.7)44 (33.9) After completion (n, %)36 (22.4)8 (6.2) 161130P<0.001 More patients were started on ART during TB treatment (94% versus 81%, P=0.001). Outdoor “One-Stop Shop” TB/HIV clinic: TB diagnosis & treatment HIV treatment Analysis of ART initiation in TB patients in 2007 (pre) versus 2009 (post) Median time to ART initiation: 101 (IQR 63, 204) to 44 (IQR 21, 105) days (P=0.01).

3. Results: Timing of ART & Outcomes P<0.001 P=0.128 P=0.318 Survival and retention improved: 52% in 2009 versus 33% in 2007 in the patients not initiated on ART (P=0.015) 83% versus 80% in the patients who were started ART (P=0.514) *P=0.011 * Outcomes: not started on ART

4. Acknowledgements IDI TB working group: Immaculate Ariko Catherine Katabira Peter Mbidde Isaac Lwanga Elly Kyolaba Jennifer Kisakye IDI Senior Management Team: Alex Coutinho IDI Data Management Team: Victor Afayo Olivia Nampewo Rosette Bukirwa Yale summer students 2007 and 2009: Betsy Lee, Ambika Bushan, Ryan Park, Nikia McFadden, Abraar Karan Sponsors INTERACT Programme European Union