SHIP is proud to share SAIL Clinic Calamba’s oral presentation at #PNCA2026, delivered by Carlo Reyes, RND. The SAIL group of clinics developed its own structured three-session enhanced adherence counseling (EAC) protocol as a quality improvement project. The protocol is anchored on the BECS
framework, which classifies factors affecting adherence as Behavioral, Emotional, Cognitive, or Socioeconomic.
We reviewed multidisciplinary case discussions among clients with unsuppressed viral load and found that adherence barriers go well beyond treatment literacy. Even though clients understood the importance of taking ART properly, they still struggled with clinic visits and competing life priorities, anxiety, depression, family stress, relocation, transportation, unstable income, and work conflicts. Some even resorted to survival-driven actions such as rationing their pills until their next refill.
These findings show that adherence support must move beyond treatment education toward individualized goal-setting, multidisciplinary case management (with medical, social work, mental health, and advocacy support), and sustained longitudinal care. Ongoing studies will assess viral re-suppression and guide scale-up across #SAILClinics.
Better adherence requires more than reminding people to take their medicine. Better adherence requires understanding the circumstances that stand in their way. 
