Differentiated models of service delivery (DSD) for antiretroviral treatment of HIV in subSaharan Africa: A review of the gray literature as of June 2019 AMBIT Project Report Number 03

By Kuchukhidze S  Dr. Lawrence Long  Dr. Sophie Pascoe  Dr. Amy Huber  Dr. Brooke Nichols  Dr. Matthew Fox  Professor Sydney Rosen  |  | 

To achieve global targets for the treatment and prevention of HIV, most high prevalence countries are working towards scaling up alternative service delivery approaches, or differentiated service delivery (DSD) models. DSD models aim to achieve a number of potential benefits to both providers and patients, including better clinical outcomes, greater patient satisfaction, lower cost, and more efficient and convenient service delivery. To date, most DSD model development and implementation has been limited to HIV positive patients on antiretroviral therapy (ART), and in particular to those deemed “stable” on ART. Models such as adherence clubs, community adherence groups, fast-track appointments, and multi-month dispensing are now being implemented and evaluated to assess their effect on achieving the benefits listed above.1–3 A few of these evaluations have been published in the formal literature,4–6 but given the recent, rapid, and extensive development of DSD guidelines and programs in many sub-Saharan African countries, most evaluations of implementation and outcomes remain unpublished, in the form of project reports, presentations, and other informal documents.

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