A Digital Innovation for Enhanced Adherence Counseling (EAC) to Improve Outcomes Among People Living With HIV (PLHIV) in Mumbai, India

Introduction Early initiation of antiretroviral therapy (ART) and adequate adherence are associated with sustained viral load (VL) suppression and effective treatment in people living with HIV (PLHIV). Enhanced adherence counseling (EAC) has been recommended for PLHIV on therapy with a VL >1000 copies/mL. We developed a digital application, "Samvaad," for counselors at ART centers to document the barriers to poor adherence and to provide thematic EAC for registered PLHIV under the aegis of the Mumbai District AIDS Control Society. The objectives of this study are to document the barriers to ART adherence in PLHIV who require EAC and to report the suppression outcomes in those who received EAC using Samvaad. Methods This study is a pre-post analysis of retrospective programmatic data from 674 PLHIV across 16 ART centers in Mumbai, India, from September 2020 to July 2022. We included only PLHIV who had unsuppressed VL and/or ART adherence