Background
This study examines the persistent distressing symptoms and concerns experienced by PLWHA despite their adherence to medication, underscoring the necessity for a holistic (looking at the whole issue from different angles) approach to enhance their Quality of Life (QoL).

A small study (feasibility trial) conducted earlier in Ghana tested a new approach to care assessment and delivery called Community-based Enhanced Care Intervention (CECI), focusing on participant recruitment and retention for a subsequent larger study.

Results indicated that both PLWHA and Healthcare Providers (HCP) found the CECI approach safe, comfortable, and beneficial. The trial successfully recruited and retained participants for this current, larger study (definite trial) named ExtraCECI.

Aim
To conduct a cluster randomised controlled trial (cRCT) to evaluate the effectiveness of community-based enhanced care intervention (ExtraCECI) compared to standard HIV care in improving quality of life and person-centred outcomes for PLWHA in Ghana.

Principal Question
Is the ExtraCECI effective in improving quality of life and person-centred outcomes for PLWHA as well as cost-effective, compared to standard HIV care?

Methods
A parallel cluster randomised controlled trial of ExtraCECI versus standard HIV care will be conducted with 1:1 allocation. Twenty-six community HIV clinics within the Greater Accra Region of Ghana will be selected and randomised, with 650 PLWHA recruited after eligibility checks and obtaining informed consent.

The study will be carried out for four years. The Medical Research Council (MRC) framework for developing and evaluating complex interventions will serve as a