Less frequent clinic visits for HIV care: fine tuning needed

Keith Alcorn

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.



July 27, 2017
Year of publication
Resource types
Conference materials, Journal and research articles
Botswana, Lesotho, Swaziland, Malawi, Uganda, Tanzania, multi-month prescribing (MMP), children, adolescents, health care facilities, viral load suppression, clinical outcomes, treatment, treatment outcomes, antiretroviral therapy, ART, loss to follow-up, medication pick-ups, health care resources, clinic visits, IAS 2017, 9th IAS Conference on HIV Science, youth, key populations, ART coverage, differentiated care, pediatric outcomes, pediatric care, prescription schedules, BIPAI, Baylor International Pediatric AIDS initiative (BIPAI)

Similar Resources

To improve antiretroviral coverage (ART) and help reach the 90-90-90 treatment targets, differentiated approaches to care are necessary, including reduced frequency of clinic visits for stable patients.

On the sidelines of the 2017 United Nations General Assembly, U.S. Secretary of State Rex Tillerson announced the new PEPFAR Strategy for Accelerating HIV/AIDS Epidemic Control (2017-2020).

Option B+ for prevention of mother-to-child transmission (PMTCT) specifies treating all HIV-positive women with antiretroviral therapy (ART) regardless of CD4 count. This simplified approach enhances countries' capacity to reach national HIV targets and contribute to the global 90-90-90 goals.…

Infants exposed to an antiretroviral regimen of tenofovir, emtricitabine and efavirenz (Atripla) from conception experienced fewer adverse birth outcomes compared to other three-drug regimens, according to a study of births in Botswana between 2014 and 2016, presented on Tuesday at the …

The USAID/TSP HIV Child and Adolescent ARV Procurement Forecasting Tool is intended to assist program managers, clinicians and support staff in quantifying and budgeting for a program’s child and adolescent ARV needs…

Baylor-Malawi, with USAID funding, has developed a special JAIDS supplement featuring 11 articles which highlight lessons and best practices from the Accelerating Children’s HIV/AIDS Treatment (ACT) Initiative, a public-private partnership that expanded pediatric HIV services in nine sub-Saharan

The Accelerating Children’s HIV/AIDS Treatment (ACT) Initiative was a public-private partnership that expanded pediatric HIV services in nine sub-Saharan African countries from 2014-2016, providing treatment to more than 560,000 children living with HIV.

An essential first step in caring for HIV-infected children is accurate and early diagnosis of HIV, early HIV testing, prompt return of results, and rapid initiation of treatment.

Sub-Saharan Africa bears more than two-thirds of the worldwide burden of HIV; however, data among transgender women from the region are sparse. Transgender women across the world face significant vulnerability to HIV.