Shifts to less frequent clinic visits and medication pick-ups to free up healthcare resources and make life easier for people living with HIV are being implemented successfully in some African countries, but still need fine tuning, several studies presented on Monday at the 9th International AIDS Society Conference on HIV Science (IAS 2017) show.
One of these was a study by Baylor International Pediatric AIDS initiative (BIPAI), which looked at the clinical outcomes of children and adolescents shifted to multi-month prescribing in in six African countries.
Although multi-month prescribing has been restricted largely to adults in Malawi, Baylor International Pediatric AIDS Initiative has been offering multi-month prescribing for children and adolescents at health care facilities in Botswana, Lesotho, Swaziland, Malawi, Uganda and Tanzania. So far, just over 15,000 children have been moved to multi-month prescribing and viral load suppression remains high. Only 1.8% of patients switched to multi-month prescribing have been lost to follow-up.
Children and adolescents were eligible for multi-month prescribing if they were clinically stable and adherent to ART, after six to nine months of monthly prescription pick-ups. On average, children and adolescents shifted to multi-month prescribing attended the clinic every 61 days, compared to a mean interval of 39 days between visits for those on monthly prescribing. Patients who shifted to multi-month prescribing tended to have better long-term outcomes, as one would expect in a group of patients selected for the intervention on the basis of good short-term outcomes.
But, said Professor Maria Kim of Baylor Children’s Foundation, the take-home message of the study was that children continued to do well after switching to multi-month prescribing. The study found no differences in loss to follow-up between different age groups switched to multi-month prescribing, nor between countries.
Find the conference abstract here.