A 28-year-old woman from Mumbai, known to be HIV-positive for 6 months on ART (tenofovir/lamivudine/efavirenz), presents with persistent fever, weight loss, and a CD4 count of 45 cells/μL despite 6 months of therapy. Viral load is 2,50,000 copies/mL. She admits to poor adherence due to side effects. What is the most appropriate immediate next step in management?

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