Differentiated Models of Delivering HIV Care: PLHIV and HCW Perspectives

Posted by Editor on November 15, 2016

The ambitious UNAIDS 90-90-90 goals and the implementation of the World Health Organization (WHO) 2015 recommendation to “treat all HIV-positive individuals on antiretroviral therapy (ART)”, has meant that already overstretched “health systems will have to re-examine how ART care is delivered.” There is a clear appreciation for the pivotal role that communities have played in the HIV response over the last 32 years. Given the ambitious targets, there is a need to maximise on functional models of HIV service delivery already being utilised in various communities, which are often ‘undocumented’.

In this context, the International AIDS Society (IAS) is working on a two-year project to support the implementation of differentiated models of ART delivery. Differentiated care is defined as “a client-centred approach that simplifies and adapts HIV services across the cascade to reflect the preferences and expectations of various groups of people living with HIV, while reducing unnecessary burdens on the health system. By providing differentiated [models of] care, the health system can refocus resources to those most in need.” The core underlying principle with Differentiated Care, is to provide ART delivery in a way that acknowledges diversity and preferences in how PLHIV access ART services, taking into considerations the various contexts within which people living with HIV present for care, and how they perform on treatment. These models are piloted, with the appreciation of the barriers faced by specific groups and to advance models that essentially “empowers them to manage their disease with the support of the health system.” 


Recognising the critical role played by communities in ensuring sustainable, responsive and effective HIV treatment outcomes, the IAS has been collaborating with the AIDS and Rights Alliance for Southern Africa (ARASA) and the International Treatment Preparedness Coalition (ITPC) to conduct a rapid assessment in 8 countries in Africa to gauge the ‘readiness’ of patients and communities to advocate for differentiated models of ART delivery. This is a preferred approach rather than assuming that this would be a positive development for all communities across the region. The aim of the rapid assessment was to collect real-time information on the perceptions of people living with HIV and communities around existing needs and gaps in the delivery of ART care, and to identify what they may see as potential barriers to the implementation of differentiated (and community-suited) ART delivery models.

Three publications were produced by ARASA and ITPC, based on the survey results:

1. Issue Brief: Differentiated Models of Delivering HIV Care: Perspectives from people living with HIV and health care workers in 7 African countries: Issue_Brief_Differentiated_Models_of_Care_PLHIV_and_HCW_perspectives.pdf

Poster: Differentiated Models of Delivering HIV Care: Perspectives from people living with HIV and health care workers in 7 African countries: 

Poster_Differentiated_Models_of_Care_PLHIV_and_HCW_perspectives.pdf

Survey Report: Differentiated Models of Delivering HIV Care: Perspectives from people living with HIV and health care workers in 7 African countries: 

Survey_Report_Differentiated_Models_of_Care_PLHIV_and_HCW_perspectives.pdf