Recruitment, Randomization, and Masking
For inclusion in the study, we selected 5 rural, Ministry of Health–supported clinics in south-western Uganda and western Kenya. The study was conducted between April 15, 2021, and June 22, 2022. Participant enrollment into the study was based on the following inclusion criteria: (1) aged 15 years or older; (2) HIV-positive; (3) enrolled or new to HIV care in a study clinic regardless of duration on ART; (4) HIV RNA nonsuppression (>400 c/mL in the prior 12 months) as per their latest results or 2 missed visits in past 12 months; and (5) ≥2 weeks with nights spent away from home and outside the community during the 12 months before enrollment. We selected a 2-week period because patients typically visit clinic and receive ART refills every 1–3 months in this setting, and we considered ≥2 weeks away from home a period of mobility likely to disrupt ART access and adherence.Consented participants were randomized to intervention or control by selecting a sequentially numbered scratch card, revealing the arm only when scratched by the participant. Participants were randomized 1:1 to the intervention and control arms using a stratified (country and sex) block design (random block sizes of 2 and 4) and followed up for a total of 48 weeks. Participants were not masked to the randomization group, but the study statistician (L.B.B.) was masked until trial completion.