Fig. 2

SPIRIT diagram of study procedures. Footnotes: ¹ Conducted 24 weeks (range: 20–28 weeks) after the visit in which the follow-up viral load result (control arm) or the GRT result (intervention arm) is first available; may coincide with another study visit. ² May be delayed upon evidence of poor adherence, defined as a pill count of <90% and/or a self-reported period of no drug intake of ≥2 days in the last 4 weeks. ³ In intervention arm: informed by GRT result. ⁴ Clinical information at ART initiation; previous ART regimens; exposure to prevention to mother-to-child transmission strategies. ⁵ Height, weight, middle upper arm circumference (if aged <5 years), nutritional status. ⁶ WHO stage; co-morbidities; symptoms and side-effects; new hospitalisation. ⁷ Female participants aged ≥12 years. GRT: genotypic resistance testing; VL: viral load