Aim 2: Evaluate the effect of the SPIRIT intervention on IPT completion and TB incidence. Even if the intervention increases IPT initiation, quantifying actual use of IPT by patients and downstream effects on population health status (e.g. reduction in TB incidence) are important to assess impact and thereby enable policy makers to prioritize this intervention more widely. A subset of adult patients who received a prescription for IPT will be randomly sampled to measure adherence through hair levels of INH (direct measure of IPT completion) and TB incidence (population health measure). IPT completion and TB incidence will also be measured on the overall population of HIV-positive adults in care at health facilities overseen by the DHOs. Within the SPIRIT intervention arm, there are nested trials for single pill combination (SPC) of INH/B6/Trimethoprim-sulfamethoxazole (TMP-SMX) vs. no-SPC for IPT and for variable prescription refill frequency (90-day vs. 30-day supply).