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Does the introduction explain the objective of the research presented in the preprint?

Yes

The authors clearly stated the objective in the last statement of the introduction: “To start to build a reliable evidence base on this topic for sub-Saharan Africa, we conducted an exploratory, mixed-methods sub-study that collected multiple indicators of prior use for a sample of ART initiators in South Africa.”

Are the methods well-suited for this research?

Somewhat appropriate

Authors clearly defined a mixed-methods approach of quantitative and qualitative data collection in Table 1. However, it is a non-random sample and lacks a baseline for viral load testing. Authors should include a baseline for viral load testing for comparison.

Are the conclusions supported by the data?

Highly supported

Interpretation of qualitative interviews were not overreaching as it was evident that the reluctance to reveal previous ART exposure was “due to the negative attitude that the healthcare providers portray towards them”. The authors recognized the limitations of their findings as it serves as exploratory results that are not generalizable to larger populations, but as a guide for future work.

Are the data presentations, including visualizations, well-suited to represent the data?

Highly appropriate and clear

Data presentations were clear and easy to follow.

How clearly do the authors discuss, explain, and interpret their findings and potential next steps for the research?

Very clearly

The authors effectively explained their findings and interpretations and summarized the strengths and limitations of their methodology but could have provided a nuanced guide for next steps, especially regarding the National Welcome Back Campaign Strategy.

Is the preprint likely to advance academic knowledge?

Moderately likely

The authors’ use of mixed-methods is novel and has implications for future interventions regarding reluctance to reveal previous ART exposure. The findings reconfirms other literature.

Would it benefit from language editing?

No

There are minor issues regarding inconsistent tense and minor misspellings that do not impact the preprint's clarity or understanding.

Would you recommend this preprint to others?

Yes, but it needs to be improved

Healthcare providers and policymakers can have an interest in using the author’s mixed methods as a guide to explore other types of disengagement of other disease treatments. Improvements include expansion of future implications.

Is it ready for attention from an editor, publisher or broader audience?

Yes, after minor changes

Competing interests

The authors declare that they have no competing interests.