<p>Tuberculosis (TB) remains a significant public health challenge among HIV-positive individuals, particularly in sub-Saharan Africa. The One-J program, a new ART drug combination therapy, was introduced to reduce comorbid infections such as TB. However, its impact on reducing the burden of TB among ART patients has not been fully assessed. Hence this study aimed to assess the impact of the One-J program on the risk of tuberculosis among HIV-positive ART patients in Awi Zone, Northwest Ethiopia, and to identify associated factors before and after the program's implementation.</p>