ART Adherence and Retention

Peer support groups, peer mentoring, adherence clubs, home ART delivery, community ART delivery, and peer-assisted medication pickups improved ART initiation and sustained treatment engagement. Home ART delivery and peer-assisted pickups reduced travel burden, time costs, clinic stigma, and missed appointments. Among newly diagnosed individuals, 61.9% achieved viral suppression within approximately one year of diagnosis. Improved adherence and retention were linked to better viral suppression in several interventions. Differentiated service delivery models reduced clinic-related barriers, especially in South Africa. Some studies reported ART adherence improvements of 10% to 30%. Objectively measured viral suppression was 70.6%, substantially below the national Ugandan target of 85.7%. Viral suppression rates were identical for PWH who reported fishing activities and the general PWH population. Self-reported viral suppression is a reliable proxy for true suppression overall, but systematically overestimates suppression among those who are virologically failing. Poor ART adherence, rather than treatment resistance, is the primary driver of viral non-suppression in this cohort.