Global Programs HIV/TB Technical Lead Presents ART Adherence Findings at INTEREST Conference

Immaculata Kessy, HIV/TB Technical Lead for Global Programs, presented recent findings on barriers and facilitators to antiretroviral therapy (ART) adherence among people living with HIV in Tanzania at the International Conference on HIV Treatment, Pathogenesis, and Prevention Research (INTEREST) held in Dar es Salaam in May.

Her poster, “Barriers and Facilitators to Antiretroviral Therapy (ART) Adherence among Virally Unsuppressed People Living with HIV (PLHIV) in Tanzania, 2025,” shared results from a qualitative assessment conducted as part of the Enhanced Adherence Counselling (EAC) program assessment.

The assessment included in-depth interviews with 51 people living with HIV across three regions of Tanzania. Participants had viral loads above 1,000 copies and had not successfully engaged with EAC services. The study explored the socioeconomic, behavioral, psychosocial, clinical, and health-system factors that influence ART adherence and continued engagement in care.

Findings highlighted several commonly cited barriers, including food insecurity, transportation costs, forgetfulness, stigma, and experiences with judgmental counselling. At the same time, participants identified key facilitators that supported adherence, including socioeconomic support, family and community support, and non-judgmental counselling.

The findings underscore the importance of addressing adherence not only as a clinical issue, but also as one shaped by daily living conditions, trust, stigma, and the quality of patient-provider interactions. By elevating the voices of people living with HIV who are experiencing challenges with viral suppression, this work provides practical insight for strengthening EAC services and improving long-term engagement in HIV care.

H2R–Geita Success Story: From Evidence to Action in Mobile Communities

Left to right: Ritha Mboneko (HIS Analyst, Global Programs Tanzania) served as field coordinator; Rosalia Munishi (Freelance) served as research assistant; and Geofrey Mchau (Epidemiologist, Tanzania Food and Nutrition Center) handled site monitoring.

The 2025 Assessing Community-Centered Strategies for Effective HIV Service Solutions (ACCESS) assessment has helped drive a rapid and coordinated response in Tanzania’s Geita Region.

Implemented by the National AIDS, STIs, and Hepatitis Control Program (NASHCoP), in collaboration with the University of California, San Francisco (UCSF) and the U.S. Centers for Disease Control and Prevention (CDC), the assessment examined factors influencing HIV prevention, testing, and treatment among small-scale mining populations.

Conducted between June and July 2025 as part of a broader assessment in Kagera and Geita, the Geita component identified gaps in HIV service access and highlighted mobility patterns, community needs, and opportunities to improve service delivery in mining communities.

What set Geita apart was the speed of response. Preliminary findings were shared early with regional stakeholders, allowing immediate action rather than waiting for the full assessment cycle to conclude.

The Geita Regional Health Management Team (RHMT), working closely with partners, quickly translated evidence into action. Through multi-sectoral engagement, stakeholders mobilized resources to expand HIV testing, introduce and strengthen PrEP services, improve access to reproductive health services, and intensify outreach in mining sites and nearby communities, including school settings.

Implementation is being reinforced through collaboration with ICAP, supporting mobile and community-based service delivery models that bring services closer to highly mobile populations. These efforts are helping address long-standing access barriers by reaching people where they live and work.

Geita has also set a clear performance target: increasing comprehensive HIV knowledge from 30% to 50% by the end of the year through strengthened risk communication and community engagement.

This emerging success story shows how timely evidence, strong coordination, and local ownership can accelerate action for underserved and mobile populations. In Geita, data is not only informing programs. It is helping drive practical changes in how HIV services are delivered.

Global Programs Research: IAS 2024

GP Tanzania at IAS 2024

George and Christen

Mtoro Mtoro, Christen Said

Global Programs Tanzania presented seven posters at IAS 2024, the 25th International AIDS Conference, showcasing findings from a survey conducted in collaboration with the Zanzibar Integrated HIV, Hepatitis, TB, and Leprosy Programme (ZIHHTLP) and the Zanzibar government. Presenting the posters were Data Analyst Mtoro Mtoro (above, left), Executive Director of the Zanzibar AIDS Commission Dr. Ahmed Khatib (above, middle), and In-Country Director Christen Said (above, right). Dr. George Rutherford (IGHS) also presented a poster on behalf of the team. A special thanks to colleagues from ZIHHTLP and the Zanzibar AIDS Commission for their invaluable contributions.

Posters presented: 

• Estimating HIV incidence among key populations in Unguja, Zanzibar, 2023

• Experiences and reporting of physical and sexual violence among key populations in Unguja, Zanzibar, 2023

• HIV and hepatitis C co-infection among people who inject drugs in Unguja, Zanzibar, 2023

• Novel questions to broaden the understanding of injection risk behaviors among people who inject drugs in Unguja, Zanzibar, 2023

• Progress towards UNAIDS 95-95-95 targets and challenges with HIV diagnosis among men who have sex with men in Unguja, Zanzibar, 2023

• Progress towards UNAIDS 95-95-95 targets and viral suppression challenges among people who inject drugs in Unguja, Zanzibar, 2023

• Uptake of pre-exposure prophylaxis among key populations in Unguja, Zanzibar, 2023

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Tifu Agaba at IAS 2024

GP Uganda group at IAS 2024

Global Programs Uganda presented, "Continuous Quality Improvement to Enhance the Quality of Recent HIV-1 Infection Surveillance: Insights and Lessons from Uganda" at IAS 2024, the 25th International AIDS Conference.

Since the 2019 launch of the Uganda HIV Recency Surveillance project (PI: Dr. George Rutherford, IGHS), Global Programs Uganda has strengthened data quality across all 15 regions of the country through continuous quality improvement (CQI) efforts. Context-specific interventions designed by health facility staff have addressed performance gaps and improved adherence to standards, even within an overburdened public health system. These CQI activities have ensured the availability of reliable data for HIV Recency surveillance stakeholders.

In addition, a manuscript has been submitted to the East African Journal of Applied Health Monitoring and Evaluation. Working on this project were Tifu Agaba and Ronald Kiranda (Global Programs Uganda); Christine Katusiime (AIDS Control Program, Ministry of Health Uganda); Willy Bikokye (USAID Uganda); Florence Namimbi (Infectious Diseases Institute, Uganda); and Laura Buback, Eva Muhanguzi, Rikita Merai, and Rachel King (UCSF IGHS).