Determinants of Anticipated Video-Supported Treatment Acceptability in Drug-Susceptible Pulmonary Tuberculosis

Setting: Twenty-three urban healthcare facilities across five geographic jurisdictions of Metropolitan Lima, Peru. Objective: To identify determinants of anticipated video-supported treatment (VST) acceptability among persons with drug-susceptible pulmonary tuberculosis. Design: Observational, cross-sectional study (August-December 2025). Anticipated acceptability was assessed across two domains: acceptability of use (desire to use VST) and willingness to comply (confidence in fulfilling VST requirements). Adjusted prevalence ratios (aPR) with 95% confidence intervals (95%CI) were estimated using robust Poisson regression with Liang-Zeger cluster-robust standard errors. Results: Among 473 participants (median age 35 years; 51.5% male), 61.3% (95%CI: 57.0%-65.9%) reported acceptability of use and 42.3% (95%CI 36.2%-49.4%) willingness to comply with VST. Educational attainment was the strongest predictor of both outcomes. The ability to record and send videos using a mobile phone and continuity of technology access were associated with acceptability of use and willingness to comply with VST, respectively. Diabetes mellitus, illicit drug use, and intention to abandon treatment were associated with reduced willingness to comply with VST. Conclusions: VST acceptability is shaped by educational attainment, digital competency, structural conditions, and clinical and behavioural profile. VST implementation should prioritise digital skills training and incorporate pre-enrolment screening for clinical vulnerability.