In:
AIDS, Ovid Technologies (Wolters Kluwer Health)
Abstract:
Differentiated service delivery (DSD) such as multi-month dispensing (MMD) aims to provide client-centered HIV services, while reducing the workload within health facilities. We assessed individual and facility factors associated with receiving 〉 3MMD and switching from ≥3MMD back to 〈 3MMD in Kenya. Methods: We conducted a retrospective cohort study of clients eligible for DSD between July 2017 and December 2019. A random sample of clients eligible for DSD was selected from 32 randomly selected facilities located in Nairobi, Kisii, and Migori counties. We used a multilevel Poisson regression model to assess the factors associated with receiving ≥3MMD, and with switching from ≥3MMD back to 〈 3MMD. Results: A total of 3,501 clients eligible for ≥3MMD were included in our analysis: 1,808 (51.6%) were receiving care in Nairobi County and the remaining 1,693 (48.4%) in Kisii and Migori counties. Overall, 65% of clients were enrolled in ≥3MMD at the time of entry into the cohort. In the multivariable model, younger age (20–24; 25–29; 30–34 vs. 50 or more years) and switching ART regimen was significantly associated with a lower likelihood of ≥3MMD uptake. Additionally, factors associated with a higher likelihood of enrollment in ≥3MMD included receiving DTG- vs. EFV-based ART regimen (aRR: 1.10; 95% CI: 1.05–1.15). Conclusion: Client-level characteristics are associated with being on ≥3MMD and the likelihood of switching from ≥3MMD to 〈 3MMD. Monitoring DSD enrollment across different populations is critical to successfully implementing these models continually.
Type of Medium:
Online Resource
ISSN:
0269-9370
,
1473-5571
DOI:
10.1097/QAD.0000000000003725
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2023
detail.hit.zdb_id:
2012212-3
Permalink