Bwelela Easy Study

SOC-RPO is a Stage 1 intervention to promote return to HIV care following a treatment lapse through routine telephone outreach. Clinic outreach workers make at least three telephone contact attempts over a 4-week period. Participants who are reached are encouraged to return to care and receive reminders regarding treatment continuity. No in-person tracing, navigation, or community-based medication delivery is provided during Stage 1. Participants who return to care within 12-18 months are re-randomized to a Stage 2 intervention. NAV+CB-Med is a Stage 2 intervention that includes all NAV services plus ongoing community-based antiretroviral medication delivery when clinically appropriate. Navigators contact participants before ART refills are due and arrange delivery of a 3- to 6-month medication supply at a mutually agreed location, consistent with Zambian guidelines. Navigators also support attendance for required clinical evaluations and viral load monitoring.

NAV+CB-Med is a Stage 1 intervention to promote return to HIV care following a treatment lapse. Trained navigators first attempt telephone contact and, when telephone contact is unsuccessful, may use available locator information and other appropriate sources to conduct in-person tracing. After contact and consent, navigators identify barriers to care, provide logistical and emotional support, facilitate re-entry or transfer as needed, and offer a one-time community-based ART delivery of approximately 30-90 days of the participant's current regimen, consistent with Zambian guidelines. Participants who return to care within 12-18 months are re-randomized to a Stage 2 intervention. SOC-RCC is a Stage 2 intervention consisting of routine adherence counseling, facility-based HIV care, and medication refills according to standard practice. Viral load is assessed approximately 6 months after return to care.

NAV+CB-Med is a Stage 1 intervention to promote return to HIV care following a treatment lapse. Navigators attempt telephone contact and may conduct in-person tracing when telephone contact is unsuccessful. After contact and consent, navigators assess barriers, provide logistical and emotional support, facilitate return or transfer to care, and offer a one-time community-based ART delivery of approximately 30-90 days when appropriate. Participants who return to care within 12-18 months are re-randomized to a Stage 2 intervention. NAV is a Stage 2 intervention in which trained navigators facilitate adherence counseling, assess barriers to care, provide appointment reminders, facilitate transfers when needed, conduct outreach following missed visits, and maintain contact between visits. Participants initially assigned to NAV+CB-Med in Stage 1 maintain their existing navigator relationship when assigned to NAV in Stage 2.

NAV+CB-Med is a Stage 1 intervention to promote return to HIV care following a treatment lapse. Navigators attempt telephone contact and may use in-person tracing when necessary. After contact and consent, navigators identify barriers to care, provide logistical and emotional support, facilitate return or transfer to care, and offer a one-time community-based ART delivery of approximately 30-90 days when appropriate. Participants who return to care within 12-18 months are re-randomized to a Stage 2 intervention. In Stage 2, participants continue NAV+CB-Med, including navigation services and the option for ongoing community-based ART delivery. Navigators generally contact participants 2-4 weeks before refills are due and may arrange delivery of a 3- to 6-month supply at a mutually agreed location, consistent with Zambian guidelines. Navigators also support attendance for required clinical monitoring and viral load testing.