Community-Based Differentiated Service Delivery Models

This short report presents a pooled analysis of two cluster-randomized trials conducted in southern Africa, focusing on community-based differentiated service delivery (DSD) models for antiretroviral treatment (ART) among newly stable individuals living with HIV. The trials aimed to assess the effectiveness of multi-month dispensing (MMD) of ART, which allows for reduced frequency of health facility visits while maintaining care quality. The study included participants who initiated ART between 6 and 12 months prior to enrollment, comparing standard-of-care with two intervention arms that provided ART at three- and six-month intervals. The primary outcome measured was retention in care after 12 months, with secondary outcomes including viral suppression and the number of unscheduled facility visits. Results indicated that retention rates were comparable across the intervention arms and standard care, suggesting that community-based DSD models can effectively support ART clients while minimizing healthcare facility visits, particularly in the context of the COVID-19 pandemic.