Most antiretroviral therapy (ART) regimens require more than 80-95% adherence to maximize the probability of viral suppression, the ultimate goal of treatment that has significant clinical benefits and can virtually eliminate HIV transmission. However, a significant proportion of people living with HIV infection (PLHIV) on treatment have sub-optimal adherence and overall, only 29% of PLHIV are virally suppressed. This problem is a result of multifaceted factors that need to be addressed in efforts to curb the HIV/AIDS pandemic. For years countries have implemented various strategies to address this gap with some innovations giving some promising results. A major concern globally remains to be paucity of proven and scalable innovations. Which is call for experts to continue innovating, studying and documenting best and scalable practices.