The study analyzed HIV treatment challenges in Zambia in 7,916 patients who had treatment failure (elevated viral load) between August 2019 and November 2021. It found that after treatment failure, only 72.2% of patients returned to the clinic within 6 months and only 70.1% had repeat viral load testing within one year. Among retested patients, 85% of those on the TLD (tenofovir/lamivudine/dolutegravir) regimen resuppressed the virus, compared to only 58.2% on the TLE (tenofovir/lamivudine/efavirenz) regimen. The researchers identified significant delays in patients returning for counselling, treatment interruptions and missed opportunities to switch to second-line treatment. The study showed that among patients who should have switched to second-line therapy, only 27.9% for TLD and 66.6% for TLE actually switched regimens within one year. The researchers recommend focusing on improving both patient and health system behavior to optimize care after HIV treatment failure.