Adherence clubs and decentralized medication delivery to support patient retention and sustained viral suppression in care: Results from a cluster-randomized evaluation of differentiated ART delivery models in South Africa

By  Matthew Fox  Sydney Rosen  Sophie Pascoe  Amy Huber  Joshua Murphy  Mokgadi Phokojoe, Marelize Gorgens, David Wilson, Yogan Pillay, Nicole Fraser-Hurt  |  | 

In this study, we found comparable DMD outcomes versus standard of care at facilities, a benefit for retention of patients in care with ACs, and apparent benefits in terms of retention (for AC patients) and sustained viral suppression (for DMD patients) among men. This suggests
the importance of alternative service delivery models for men and of communitybased strategies to decongest primary healthcare facilities. Because these strategies also reduce patient inconvenience and decongest clinics, comparable outcomes are a potential success. The cost of all five AGL interventions and possible effects on reducing clinic congestion should be investigated.

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PLOS Medicine