MOAE0201 | CAN STANDARD ENHANCED ADHERENCE COUNSELLING BE TAILORED TO BETTER MEET THE NEEDS OF IN-CARE PLHIV AT RISK OF CARE DISENGAGEMENT?

Matilda Mlowe¹, Jillian Kadota², Sekela Mwaipopo¹, Babuu Joseph¹, Laura Packel³, Rebecca Hemono², Solis Winters², Amon Sabasaba¹, Jingshen Wang², Sandra I. Mccoy⁴ | ¹Health For A Prosperous Nation, Dar Es Salaam, Tanzania; ²University of California, Berkeley, USA; ³University of California, San Francisco, USA; ⁴Gilead Sciences, Foster City, USA

This study is an ongoing parallel-arm randomized trial in the Geita region, Tanzania, assessing the effectiveness of a tailored EAC intervention on 12-month viral load suppression for in-care PLHIV predicted to be at risk of disengagement using a machine learning algorithm. Individuals identified as at risk were randomized 1:1 to three once-monthly tailored EAC sessions plus up to three financial incentives (~$10 USD/session) or to standard HIV services. The sessions were adapted to include key topics not covered in standard EAC: status disclosure, support networks, HIV prevention for partners, and establishment of health-related goals. Surveys were conducted among PLHIV who completed counseling to assess perceptions and acceptability of the program. Between October 23, 2023, and January 20, 2025, 692 participants were enrolled in the study, 530 females and 162 males. Of these, 346 were assigned to the intervention arm. 96% of intervention participants agreed that participating in the tailored counseling sessions improved their medication adherence and supported ongoing HIV care engagement. 94.8% agreed that they did not find it difficult to incorporate the counseling sessions in their existing clinical visit schedules. 12.5% of intervention participants viewed their enrollment in these sessions as a punishment; however, only 3.7% reported that they would avoid these sessions. These findings suggest that the adapted counseling sessions were acceptable for PLHIV and provide a preliminary signal of their potential to encourage retention in care during a sensitive time when patients are at risk of disengagement. Some patients perceived the sessions as punitive, indicating a need to improve communication on the intervention’s purpose and address stigma related to supportive care. By exploring participants’ views, we gained early insights into the potential of counseling programs to support medication adherence and retention in HIV care, offering more definitive evidence on the effectiveness of this approach, guiding future interventions, and informing policy.