**5. Conclusions**

We successfully modelled the CAS of factors influencing HIVDR in the Ukonga and Gongolamboto areas of Dar es Salaam, Tanzania. The model provides a detailed understanding of the mechanisms that locally drive HIVDR, based on which we suggested three local leverage points. Together this forms a strong basis for the design of sustainable, complexity-informed interventions, tailored to the local context of the study site.

**Supplementary Materials:** The following are available online at https://www.mdpi.com/article/ 10.3390/pathogens10121535/s1, Figure S1: data saturation elements, Figure S2: data saturation connections, Figure S3: Systems map representing the CAS of factors related to HIVDR in the study site, Table S1: table containing all elements and connections.

**Author Contributions:** Conceptualization, A.K., A.-M.V., I.H.M., G.M.B., A.M., C.D., N.V., O.S., R.Z.S. and J.K.; Methodology, A.K., I.H.M., A.M., C.D. and B.D.d.C.; Validation, A.K., A.-M.V., B.D.d.C. and I.H.M.; Analysis, A.K., L.Z. and I.H.M.; Investigation, A.K., L.Z. and I.H.M.; Resources, A.M., I.H.M., G.M.B. and A.K.; Data Curation, A.K. and L.Z.; Writing—Original Draft Preparation, A.K.; Writing—Review and Editing, A.K., L.Z., I.H.M., G.M.B., B.D.d.C., A.M., N.V., C.D., O.S., R.Z.S., J.K., A.-M.V., A.S. and P.C.; Visualization, A.K.; Supervision, A.-M.V., J.K., R.Z.S., A.S. and P.C.; Project Administration, A.K.; Funding Acquisition, A.-M.V., A.K., R.Z.S. and J.K. All authors have read and agreed to the published version of the manuscript.

**Funding:** This research and the APC were funded by VLIR-UOS, gran<sup>t</sup> number TZ2019SIN263.

**Institutional Review Board Statement:** The study was conducted according to the guidelines of the Declaration of Helsinki, and approved by the Institutional Review Board of MUHIMBILI UNIVER-SITY FOR HEALTH AND ALLIED SCIENCES (protocol code No.DA.282/293/03/C/69, approved on 24 May 2019).

**Informed Consent Statement:** Informed consent was obtained from all subjects involved in the study.

**Data Availability Statement:** All data generated or analyzed during this study is included in this published article and its supplementary information files.

**Acknowledgments:** The authors thank the study participants and experts for sharing their insights. We also thank Winfrida Onesmo and Mwasiti Sadala for their help with translations and the DUCS field workers for accommodating the study and recruiting study participants.

**Conflicts of Interest:** The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results. AV declares consultancy fee from Gilead.
