Setting and Participants
AIDS, viremia
AIDS, COMMUNICABLE DISEASE, TUBERCULOSIS, VIREMIA
This study was planned to start in April 2020 at the Prince Cyril Zulu Communicable Disease Centre (PCZ CDC), a large, public clinic next to the central Durban transport hub, with support from the adjacent Centre for the AIDS Programme of Research in South Africa (CAPRISA) eThekwini Clinical Research Site. Owing to COVID-19–related challenges with enrolment, we decided to expand to an additional clinic, which opened in January 2022. This was a rural, medium-sized, primary care clinic in the uMgungundlovu District, Mafakathini Clinic, with support from the adjacent CAPRISA Vulindlela Clinical Research Site. The clinic is located in a rural part of the uMgungudlovu District. Both sites provide HIV, tuberculosis, and other primary care services and are in the province of KwaZulu-Natal, which has an estimated HIV prevalence of 27% among adults aged 15–49 years.HIV treatment is provided free at the point of service, according to South African Department of Health guidelines,People were eligible for enrolment into POwER if they were living with HIV, aged 18 years or older, receiving first-line efavirenz- or dolutegravir-based ART, had their latest VL ≥1000 copies/mL within the past 6 weeks, and had not received enhanced adherence counselling for this episode of viremia. Pregnant women were not eligible as guidelines for VL monitoring and management of viremia differ in pregnancy.