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Objectives: To examine if point-of-care urine tenofovir testing-informed counseling could be used to improve virologic suppression (VS) among participants with virologic failure (VF) after ≥1 prior round of enhanced adherence counseling (EAC)., Methods: Participants were enrolled from 42 clinics across Namibia. At each monthly medication pick-up, participants completed the point-of-care urine test and received EAC informed by this testing (EAC+). If VS was not achieved after 3 months of EAC+, up to 3 additional rounds of EAC+ were provided, with resistance testing at month (M)9., Results: Of 310 potentially-eligible participants across 42 clinics in Namibia, we enrolled 211 participants with VF (median age 33 years, 61% female); 195 reached M3 defined as receiving EAC+ and follow-up viral load testing; 169 achieved VS within M3 (87%, p<0 . 001) and 97% by M9 (181/186) compared to 40% (22/55) prior to the intervention (p<0.001). Resistance testing was performed in five remaining participants with VF at M9, of whom 1/5 (20%) developed dolutegravir resistance., Conclusions: The urine tenofovir assay when incorporated into adherence counseling has potential to be a cost-effective intervention among participants failing tenofovir-based regimens, increasing VS to 97% in those failing TLD. Encouraging results of this pre-post intervention will be rigorously tested in a randomized trial., Competing Interests: Declaration of competing interest The authors report no conflicts of interest, (Copyright © 2024. Published by Elsevier Ltd.)

Background: Cancer has great implications for psychological, social, economic, and emotional dimensions. Psychological distress is overwhelming among cancer patients following a confirmed diagnosis. However, little is known about the prevalence of psychological distress and associated factors among cancer patients in Africa Sub-Saharan. Thus, this study aimed to assess the prevalence of psychological distress and associated factors among cancer patients in public hospitals in Addis Ababa, Ethiopia., Methods: An institution-based cross-sectional study was conducted among cancer patients from September 15, 2019, to June 30, 2020. A total of 386 cancer patients selected through a simple random sampling technique participated in the study. Data were collected by an interview-administered questionnaire to evaluate psychological distress with a distress thermometer and social support with the Oslo 3-items Social Support Scale. The collected data were entered into Epi-data version 4.2 and exported into SPSS 25 for analysis, and then binary and multivariate logistic regressions were done to identify the association between dependent and independent variables., Results: A total of 386 study participants were included in the study with a response rate of 91.4%. The prevalence of psychological distress among cancer patients in public hospitals in Addis Ababa, Ethiopia was 64.5%. Age > 45 years [AOR = 0.41; 95% CI (0.22-0.77)], marital status of being divorced [AOR = 3.3; 95%CI (1.23-8.71)] and married [AOR = 3.2; 95%CI (1.03-10.40)], rural residence [AOR = 1.5; 95%CI (1.15-5.18)], cancer stage II [AOR = 3.9; 95%CI (1.90-15.50)], stage III [AOR = 3.5;95%CI (1.45-8.44)] and stage IV [AOR = 3.4; 95%CI (1.90-10.11)], co-morbidity [AOR = 0.07; 95%CI: (0.03-0.17)], and moderate social support [AOR = 0.36; 95%CI (0.14-0.60)] and strong social support [AOR = 0.06; 95%CI (0.03-0.12)] were found to be significantly associated with psychological distress., Conclusion: The prevalence of psychological distress among cancer patients in public hospitals in Addis Ababa, Ethiopia was high, and age, marital status, place of residence, cancer stage, co-morbidity, and social support were associated with psychological distress. Therefore, interventions focusing on these findings require special emphasis during designing interventions aimed at decreasing psychological distress., (© 2023. The Author(s).)