PHASE 1 Inclusion Criteria:  18 years of age or older Reports injection drug use in prior 24 months Documented HIV positive Antiretroviral therapy naïve HIV RNA 1,000 c/mL or higher If previously linked to HIV care, able and willing to provide govt. ART book for documentation of care received.  PHASE 1 Exclusion Criteria:  Pregnant (if female) Does not speak English, Hindi, or local language Plans to migrate in next 12 months Not competent to participate in the study or provide written informed consent.  PHASE 2 Inclusion Criteria:  • Participants who experience treatment failure at 6 months (HIV RNA>1000c/mL)  PHASE 2 Exclusion Criteria:  • Participants who do not experience treatment failure at 6 months