{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T15:02:55Z","timestamp":1784818975587,"version":"3.55.0"},"reference-count":19,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Vanke School of Public Health, Tsinghua University"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Int Assoc Provid AIDS Care"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Routine viral load testing (VLT) is critical for monitoring HIV treatment effectiveness, yet adherence to annual testing and patient engagement remain suboptimal, particularly among women. We evaluated a peer educator\u2013supported, patient-initiated VLT approach in Dar es Salaam, Tanzania.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In 2024, a two-arm cluster-randomized trial was conducted across six public HIV clinics. Intervention sites implemented a 4\u20136-month peer-supported program promoting patient-initiated VLT, while control sites continued routine care. Data from adult PLHIV were analyzed using regression models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 567 participants, 14.8% had not tested within 12 months, with higher non-testing among men (19.7% vs. 12.2%, p=0.019). Intervention sites showed higher mean numbers tested for men (65 vs. 26) and women (146.4 vs. 57). Although patient-initiated testing was infrequent overall (2.8%), the intervention arm demonstrated higher odds of patient-initiated viral load testing than the control arm (aOR=4.69; 95% CI: 1.30\u201316.95).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Peer-supported strategies improved patient-initiated VLT and female engagement but require stronger health system support.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23259582261471973","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T13:20:16Z","timestamp":1784640016000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Toward Empowering Women in HIV Care: A Peer-Supported Patient-Initiated Viral Load Testing Cluster-Randomized Trial in Dar es Salaam, Tanzania"],"prefix":"10.1177","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8171-7094","authenticated-orcid":false,"given":"Peter","family":"Karoli","sequence":"first","affiliation":[{"name":"National Institute for Medical Research-Tanzania (NIMR)"},{"name":"Muhimbili University of Health and Allied Sciences (MUHAS)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gibson B.","family":"Kagaruki","sequence":"additional","affiliation":[{"name":"National Institute for Medical Research-Tanzania (NIMR)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Shayo","sequence":"additional","affiliation":[{"name":"National Institute for Medical Research-Tanzania (NIMR)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayoub","family":"Kibao","sequence":"additional","affiliation":[{"name":"Ministry of Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ndeniria","family":"Swai","sequence":"additional","affiliation":[{"name":"Ministry of Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhihui","family":"Li","sequence":"additional","affiliation":[{"name":"Tsinghua University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,21]]},"reference":[{"key":"e_1_3_9_2_2","unstructured":"UNAIDS. The Path That Ends AIDS: UNAIDS Global AIDS Update. 2023. https:\/\/www.wipo.int\/amc\/en\/mediation\/rules"},{"key":"e_1_3_9_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.26258\/full"},{"key":"e_1_3_9_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.25921\/full"},{"key":"e_1_3_9_5_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12939-019-1055-6"},{"key":"e_1_3_9_6_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-13-220"},{"key":"e_1_3_9_7_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pgph.0003042"},{"key":"e_1_3_9_8_2","volume-title":"Strengthening Health Systems: Improving Health Security. WHO Regional Office for Africa","author":"WHO","year":"2017","unstructured":"WHO. Strengthening Health Systems: Improving Health Security. WHO Regional Office for Africa. World Health Organization; 2017."},{"key":"e_1_3_9_9_2","doi-asserted-by":"publisher","DOI":"10.7448\/IAS.16.1.18586"},{"key":"e_1_3_9_10_2","unstructured":"Perry Hand CL. Developing and Strengthening Community Health Worker Programs at Scale: A Reference Guide for Program Managers and Policy Makers. 2014."},{"key":"e_1_3_9_11_2","doi-asserted-by":"publisher","DOI":"10.1071\/SH22052"},{"key":"e_1_3_9_12_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12910-018-0312-3"},{"key":"e_1_3_9_13_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-024-11747-w"},{"key":"e_1_3_9_14_2","volume-title":"Point-of-Care HIV Viral Load Testing: An Essential Tool for a Sustainable Global HIV\/AIDS Response","author":"Drain PK","year":"2013","unstructured":"Drain PK, Dorward J, Bender A, et al. Point-of-Care HIV Viral Load Testing: An Essential Tool for a Sustainable Global HIV\/AIDS Response; 2013."},{"key":"e_1_3_9_15_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-016-1784-9"},{"key":"e_1_3_9_16_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.e5661"},{"key":"e_1_3_9_17_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-045373"},{"key":"e_1_3_9_18_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0220159"},{"key":"e_1_3_9_19_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002822"},{"key":"e_1_3_9_20_2","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa1105243"}],"container-title":["Journal of the International Association of Providers of AIDS Care (JIAPAC)"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/23259582261471973","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/23259582261471973","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/23259582261471973","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T14:21:37Z","timestamp":1784816497000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/23259582261471973"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":19,"alternative-id":["10.1177\/23259582261471973"],"URL":"https:\/\/doi.org\/10.1177\/23259582261471973","relation":{},"ISSN":["2325-9582","2325-9582"],"issn-type":[{"value":"2325-9582","type":"print"},{"value":"2325-9582","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"article-number":"23259582261471973"}}