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Article History

Received: 23 December 2024

Accepted: 6 March 2026

First Online: 20 March 2026

Declarations

:

: The KIULARCO was approved by the Ifakara Health Institute Review Board (IHI/IRB/No:16-2006) and the National Health Research Committee of the National Institute of Medical Research of Tanzania (NIMR/HQ/R.8a/Vol. IX/620) with yearly approval extensions. Upon registration at CDCI, all PLHIV individuals aged ≥ 18 years were informed about KIULARCO, and written informed consent was obtained for recruitment into the KIULARCO. In PLHIV aged < 18 years, parents or guardians/caregivers were informed about research done in KIULARCO, and for those who agreed, written informed consent was provided by parents or responsible guardian/caregiver on behalf of PLHIV aged < 18 years. PLHIV who did not consent to participate in KIULARCO, their decision did not affect HIV care and treatment services provision, because these services are provided to all PLHIV enrolled in care following Tanzanian HIV and AIDS management guidelines. The study adhered to the Declaration of Helsinki, and there were no potential risks to participants recruited in KIULARCO and included in this study. Furthermore, this study is part of the Ph.D. project embedded within the KIULARCO. The Ph.D. was approved by the University of the Witwatersrand Human Research Ethics Committee (Medical) (Ref: R14/49).

: Not applicable.

: Other authors have declared no conflict of interest, except A.V.K., who received funds from the Consortium for Advanced Research Training in Africa (CARTA) for the Ph.D. studies, and this article is part of the Ph.D. outcome and received payment from the Kilombero and Ulanga Antiretroviral Cohort (KIULARCO) through Ifakara Health Institute. A.M. had grants from the National Institute of Health, the Bill and Melinda Gates Foundation, and Gilead. F.V. and T.R.G. received payment from KIUALRCO through the Swiss Tropical and Public Health Institute.