differentiated models of ART delivery

Differentiated Antiretroviral Therapy Delivery: Implementation Barriers and Enablers in South Africa

Scale-up of antiretroviral therapy (ART) for people living with HIV requires differentiated models of ART delivery to improve access and contribute to achieving viral suppression for 95% of people on ART. We examined barriers and enablers in South Africa via semistructured interviews with 33 respondents (program implementers, nurses, and other health care providers) from 11 organizations.
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“It's time to deliver differently”

Differentiated service delivery (DSD) has increasingly become the norm for HIV service providers and their clients; and not a moment too soon. In southern Africa, we are all too familiar with the one-size-fits-all approach to service delivery and the resulting challenges of overburdened facilities, long queues, exhausted healthcare workers, and poor client adherence.

Author
Jon Crisp, Baylor College of Medicine Children's Foundation Malawi/SHARE staff

A Decision Framework for differentiated antiretroviral therapy delivery for key populations

Author
International AIDS Society (IAS)

This Framework draws purposeful attention to men who have sex with men, transgender people, people who inject drugs and sex workers. The framework outlines the methodology for identifying specific challenges, deciding what DSD models may solve these challenges and how to systematically adapt or build a differentiated model of ART delivery for a specific key population.

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A Decision Framework for differentiated antiretroviral therapy delivery for children, adolescents and pregnant and breastfeeding women

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Yes

A Decision Framework for ART Delivery for children, adolescents and pregnant and breastfeeding women, or the Decision Framework for Specific Populations as it is referred to throughout this document for ease, is aimed at supporting HIV programme managers at the national and district level to adapt or build differentiated models of ART delivery.

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High rates of retention and viral suppression in the scale-up of antiretroviral therapy adherence clubs in Cape Town, South Africa

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Yes
Author
Priscilla Ruvimbo Tsondai, Lynne Susan Wilkinson, Anna Grimsrud, Precious Thembekile Mdlalo, Angelica Ullauri, Andrew Boulle

Increasingly, there is a need for health authority scale up of successfully piloted differentiated models of antiretroviral therapy (ART) delivery. However, there is a paucity of evidence on system-wide outcomes after scale-up. In the Cape Town health district, stable adult patients were referred to adherence clubs (ACs) – a group model of ART delivery with five visits per year. By the end of March 2015, over 32,000 ART patients were in an AC. We describe patient outcomes of a representative sample of AC patients during this scale-up.

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