PLOS Global Public Health (Jan 2022)

Retention on ART and viral suppression among patients in alternative models of differentiated HIV service delivery in KwaZulu-Natal, South Africa.

  • Altynay Shigayeva,
  • Ntombi Gcwensa,
  • Celiwe Dlamini Ndlovu,
  • Nosicelo Ntumase,
  • Scelinhlanhla Sabela,
  • Liesbet Ohler,
  • Laura Trivino-Duran,
  • Ellie Ford Kamara,
  • Khanyo Hlophe,
  • Petros Isaakidis,
  • Gilles Van Cutsem

DOI
https://doi.org/10.1371/journal.pgph.0000336
Journal volume & issue
Vol. 2, no. 12
p. e0000336

Abstract

Read online

Differentiated models of HIV care (DMOC) aim to improve health care efficiency. We describe outcomes of five DMOC in KwaZulu-Natal, South Africa: facility adherence clubs (facility AC) and community adherence clubs (community AC), community antiretroviral treatment (ART) groups (CAG), spaced fast lane appointments (SFLA), and community pick up points (PuP). This retrospective cohort study included 8241 eligible patients enrolled into DMOC between 1/1/2012 and 31/12/2018. We assessed retention in DMOC and on ART, and viral load suppression (200-399 copies/mL) was associated with higher hazards of VL rebound and attrition from ART. Concurrent implementation of several DMOC in a large ART program is feasible and can achieve sustained retention on ART and VL suppression.