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Uptake of community‐ versus clinic‐based antiretroviral therapy dispensing in the Central Chronic Medication Dispensing and Distribution program in South Africa
Introduction South Africa's government‐led Central Chronic Medication Dispensing and Distribution (CCMDD) program offers people living with HIV the option to collect antiretroviral therapy at their choice of community‐ or clinic‐based pick‐up points intended to increase convenience and deconges...
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| Published in: | Journal of the International AIDS Society 2022-01, Vol.25 (1), p.e25877-n/a |
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| creator | Bassett, Ingrid V. Yan, Joyce Govere, Sabina Khumalo, Anele Ngobese, Nompumelelo Shazi, Zinhle Nzuza, Mpilonhle Bunda, Bridget A. Wara, Nafisa J. Stuckwisch, Ashley Zionts, Dani Dube, Nduduzo Tshabalala, Sandile Bogart, Laura M. Parker, Robert A. |
| description | Introduction
South Africa's government‐led Central Chronic Medication Dispensing and Distribution (CCMDD) program offers people living with HIV the option to collect antiretroviral therapy at their choice of community‐ or clinic‐based pick‐up points intended to increase convenience and decongest clinics. To understand CCMDD pick‐up point use among people living with HIV, we evaluated factors associated with uptake of a community‐ versus clinic‐based pick‐up point at CCMDD enrolment.
Methods
We collected baseline data from October 2018 to March 2020 on adults (≥18 years) who met CCMDD clinical eligibility criteria (non‐pregnant, on antiretroviral therapy for ≥1 year and virologically suppressed) as part of an observational cohort in seven public clinics in KwaZulu‐Natal. We identified factors associated with community‐based pick‐up point uptake and fit a multivariable logistic regression model, including age, gender, employment status, self‐perceived barriers to care, self‐efficacy, HIV‐related discrimination, and perceived benefits and challenges of CCMDD.
Results and Discussion
Among 1521 participants, 67% were females, with median age 36 years (IQR 30–44). Uptake of a community‐based pick‐up point was associated with younger age (aOR 1.18 per 10‐year decrease, 95% CI 1.05–1.33), being employed ≥40 hours per week (aOR 1.42, 95% CI 1.10–1.83) versus being unemployed, no self‐perceived barriers to care (aOR 1.42, 95% CI 1.09–1.86) and scoring between 36 and 39 (aOR 1.44, 95% CI 1.03–2.01) or 40 (aOR 1.91, 95% CI 1.39–2.63) versus 10–35 on the self‐efficacy scale, where higher scores indicate greater self‐efficacy. Additional factors included more convenient pick‐up point location (aOR 2.32, 95% CI 1.77–3.04) or hours (aOR 5.09, 95% CI 3.71–6.98) as perceived benefits of CCMDD, and lack of in‐clinic follow‐up after a missed collection date as a perceived challenge of CCMDD (aOR 4.37, 95% CI 2.30–8.31).
Conclusions
Uptake of community‐based pick‐up was associated with younger age, full‐time employment, and systemic and structural factors of living with HIV (no self‐perceived barriers to care and high self‐efficacy), as well as perceptions of CCMDD (convenient pick‐up point location and hours, lack of in‐clinic follow‐up). Strategies to facilitate community‐based pick‐up point uptake should be tailored to patients’ age, employment, self‐perceived barriers to care and self‐efficacy to maximize the impact of CCMDD in decongesting clinics. |
| doi_str_mv | 10.1002/jia2.25877 |
| format | article |
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South Africa's government‐led Central Chronic Medication Dispensing and Distribution (CCMDD) program offers people living with HIV the option to collect antiretroviral therapy at their choice of community‐ or clinic‐based pick‐up points intended to increase convenience and decongest clinics. To understand CCMDD pick‐up point use among people living with HIV, we evaluated factors associated with uptake of a community‐ versus clinic‐based pick‐up point at CCMDD enrolment.
Methods
We collected baseline data from October 2018 to March 2020 on adults (≥18 years) who met CCMDD clinical eligibility criteria (non‐pregnant, on antiretroviral therapy for ≥1 year and virologically suppressed) as part of an observational cohort in seven public clinics in KwaZulu‐Natal. We identified factors associated with community‐based pick‐up point uptake and fit a multivariable logistic regression model, including age, gender, employment status, self‐perceived barriers to care, self‐efficacy, HIV‐related discrimination, and perceived benefits and challenges of CCMDD.
Results and Discussion
Among 1521 participants, 67% were females, with median age 36 years (IQR 30–44). Uptake of a community‐based pick‐up point was associated with younger age (aOR 1.18 per 10‐year decrease, 95% CI 1.05–1.33), being employed ≥40 hours per week (aOR 1.42, 95% CI 1.10–1.83) versus being unemployed, no self‐perceived barriers to care (aOR 1.42, 95% CI 1.09–1.86) and scoring between 36 and 39 (aOR 1.44, 95% CI 1.03–2.01) or 40 (aOR 1.91, 95% CI 1.39–2.63) versus 10–35 on the self‐efficacy scale, where higher scores indicate greater self‐efficacy. Additional factors included more convenient pick‐up point location (aOR 2.32, 95% CI 1.77–3.04) or hours (aOR 5.09, 95% CI 3.71–6.98) as perceived benefits of CCMDD, and lack of in‐clinic follow‐up after a missed collection date as a perceived challenge of CCMDD (aOR 4.37, 95% CI 2.30–8.31).
Conclusions
Uptake of community‐based pick‐up was associated with younger age, full‐time employment, and systemic and structural factors of living with HIV (no self‐perceived barriers to care and high self‐efficacy), as well as perceptions of CCMDD (convenient pick‐up point location and hours, lack of in‐clinic follow‐up). Strategies to facilitate community‐based pick‐up point uptake should be tailored to patients’ age, employment, self‐perceived barriers to care and self‐efficacy to maximize the impact of CCMDD in decongesting clinics.</description><identifier>ISSN: 1758-2652</identifier><identifier>EISSN: 1758-2652</identifier><identifier>DOI: 10.1002/jia2.25877</identifier><identifier>PMID: 35077611</identifier><language>eng</language><publisher>Switzerland: John Wiley & Sons, Inc</publisher><subject>Acquired immune deficiency syndrome ; Adult ; Africa ; AIDS ; Ambulatory Care Facilities ; Antiretroviral agents ; Antiretroviral drugs ; ARV ; Chronic illnesses ; Clinics ; Cohort analysis ; Cohort Studies ; community ; Cost control ; differentiated care ; Drug therapy ; Female ; Health care policy ; HIV ; HIV care continuum ; HIV Infections - drug therapy ; Human immunodeficiency virus ; Humans ; Male ; Mental health ; Patients ; Public sector ; Short Report ; Social support ; South Africa ; Stigma</subject><ispartof>Journal of the International AIDS Society, 2022-01, Vol.25 (1), p.e25877-n/a</ispartof><rights>2022 The Authors. published by John Wiley & Sons Ltd on behalf of the International AIDS Society.</rights><rights>2022 The Authors. Journal of the International AIDS Society published by John Wiley & Sons Ltd on behalf of the International AIDS Society.</rights><rights>2022. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4487-c126381d0b6f2ab32bd127dffb952dcf9339a23dc4f35ac5b20e5c839d9d41123</citedby><cites>FETCH-LOGICAL-c4487-c126381d0b6f2ab32bd127dffb952dcf9339a23dc4f35ac5b20e5c839d9d41123</cites><orcidid>0000-0001-6920-6080</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2622923426/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2622923426?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,315,730,783,787,888,11575,25766,27937,27938,37025,37026,38529,43908,44603,46065,46489,53805,53807,74747,75461</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35077611$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bassett, Ingrid V.</creatorcontrib><creatorcontrib>Yan, Joyce</creatorcontrib><creatorcontrib>Govere, Sabina</creatorcontrib><creatorcontrib>Khumalo, Anele</creatorcontrib><creatorcontrib>Ngobese, Nompumelelo</creatorcontrib><creatorcontrib>Shazi, Zinhle</creatorcontrib><creatorcontrib>Nzuza, Mpilonhle</creatorcontrib><creatorcontrib>Bunda, Bridget A.</creatorcontrib><creatorcontrib>Wara, Nafisa J.</creatorcontrib><creatorcontrib>Stuckwisch, Ashley</creatorcontrib><creatorcontrib>Zionts, Dani</creatorcontrib><creatorcontrib>Dube, Nduduzo</creatorcontrib><creatorcontrib>Tshabalala, Sandile</creatorcontrib><creatorcontrib>Bogart, Laura M.</creatorcontrib><creatorcontrib>Parker, Robert A.</creatorcontrib><title>Uptake of community‐ versus clinic‐based antiretroviral therapy dispensing in the Central Chronic Medication Dispensing and Distribution program in South Africa</title><title>Journal of the International AIDS Society</title><addtitle>J Int AIDS Soc</addtitle><description>Introduction
South Africa's government‐led Central Chronic Medication Dispensing and Distribution (CCMDD) program offers people living with HIV the option to collect antiretroviral therapy at their choice of community‐ or clinic‐based pick‐up points intended to increase convenience and decongest clinics. To understand CCMDD pick‐up point use among people living with HIV, we evaluated factors associated with uptake of a community‐ versus clinic‐based pick‐up point at CCMDD enrolment.
Methods
We collected baseline data from October 2018 to March 2020 on adults (≥18 years) who met CCMDD clinical eligibility criteria (non‐pregnant, on antiretroviral therapy for ≥1 year and virologically suppressed) as part of an observational cohort in seven public clinics in KwaZulu‐Natal. We identified factors associated with community‐based pick‐up point uptake and fit a multivariable logistic regression model, including age, gender, employment status, self‐perceived barriers to care, self‐efficacy, HIV‐related discrimination, and perceived benefits and challenges of CCMDD.
Results and Discussion
Among 1521 participants, 67% were females, with median age 36 years (IQR 30–44). Uptake of a community‐based pick‐up point was associated with younger age (aOR 1.18 per 10‐year decrease, 95% CI 1.05–1.33), being employed ≥40 hours per week (aOR 1.42, 95% CI 1.10–1.83) versus being unemployed, no self‐perceived barriers to care (aOR 1.42, 95% CI 1.09–1.86) and scoring between 36 and 39 (aOR 1.44, 95% CI 1.03–2.01) or 40 (aOR 1.91, 95% CI 1.39–2.63) versus 10–35 on the self‐efficacy scale, where higher scores indicate greater self‐efficacy. Additional factors included more convenient pick‐up point location (aOR 2.32, 95% CI 1.77–3.04) or hours (aOR 5.09, 95% CI 3.71–6.98) as perceived benefits of CCMDD, and lack of in‐clinic follow‐up after a missed collection date as a perceived challenge of CCMDD (aOR 4.37, 95% CI 2.30–8.31).
Conclusions
Uptake of community‐based pick‐up was associated with younger age, full‐time employment, and systemic and structural factors of living with HIV (no self‐perceived barriers to care and high self‐efficacy), as well as perceptions of CCMDD (convenient pick‐up point location and hours, lack of in‐clinic follow‐up). Strategies to facilitate community‐based pick‐up point uptake should be tailored to patients’ age, employment, self‐perceived barriers to care and self‐efficacy to maximize the impact of CCMDD in decongesting clinics.</description><subject>Acquired immune deficiency syndrome</subject><subject>Adult</subject><subject>Africa</subject><subject>AIDS</subject><subject>Ambulatory Care Facilities</subject><subject>Antiretroviral agents</subject><subject>Antiretroviral drugs</subject><subject>ARV</subject><subject>Chronic illnesses</subject><subject>Clinics</subject><subject>Cohort analysis</subject><subject>Cohort Studies</subject><subject>community</subject><subject>Cost control</subject><subject>differentiated care</subject><subject>Drug therapy</subject><subject>Female</subject><subject>Health care policy</subject><subject>HIV</subject><subject>HIV care continuum</subject><subject>HIV Infections - drug therapy</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Male</subject><subject>Mental health</subject><subject>Patients</subject><subject>Public sector</subject><subject>Short Report</subject><subject>Social support</subject><subject>South Africa</subject><subject>Stigma</subject><issn>1758-2652</issn><issn>1758-2652</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>COVID</sourceid><sourceid>PIMPY</sourceid><recordid>eNp9kUtuFDEQhi0EIsnAhgMgS2xQpAl2uZ8bpNHwCgpiAVlbbj9mPHTbHds9aHYcgUNwMk5CdzqEwIKV7arPn6r0I_SEkjNKCLzYWQFnkFdleQ8d0zKvllDkcP_O_QidxLgjpIAqqx-iI5aTsiwoPUY_LvskvmjsDZa-6wZn0-Hnt-94r0McIpatdVaOhUZErbBwyQadgt_bIFqctjqI_oCVjb120boNtm6q4rV2aSLW2-BHAf6glZUiWe_wqz-wcGp6pmCb4brXB78Jopssn_yQtnhlwvjvEXpgRBv145tzgS7fvP68fre8-Pj2fL26WMosq8qlpFCwiirSFAZEw6BRFEplTFPnoKSpGasFMCUzw3Ih8waIzmXFalWrjFJgC_Ry9vZD02kl5yV4H2wnwoF7YfnfHWe3fOP3vCqrGrJJ8PxGEPzVoGPinY1St61w2g-RQwFQFxkdJ1mgZ_-gOz8EN643U8CycZsFOp0pGXyMQZvbYSjhU_h8Cp9fhz_CT--Of4v-TnsE6Ax8ta0-_EfF35-vYJb-AkOewB4</recordid><startdate>202201</startdate><enddate>202201</enddate><creator>Bassett, Ingrid V.</creator><creator>Yan, Joyce</creator><creator>Govere, Sabina</creator><creator>Khumalo, Anele</creator><creator>Ngobese, Nompumelelo</creator><creator>Shazi, Zinhle</creator><creator>Nzuza, Mpilonhle</creator><creator>Bunda, Bridget A.</creator><creator>Wara, Nafisa J.</creator><creator>Stuckwisch, Ashley</creator><creator>Zionts, Dani</creator><creator>Dube, Nduduzo</creator><creator>Tshabalala, Sandile</creator><creator>Bogart, Laura M.</creator><creator>Parker, Robert A.</creator><general>John Wiley & Sons, Inc</general><general>John Wiley and Sons Inc</general><scope>24P</scope><scope>WIN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>COVID</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-6920-6080</orcidid></search><sort><creationdate>202201</creationdate><title>Uptake of community‐ versus clinic‐based antiretroviral therapy dispensing in the Central Chronic Medication Dispensing and Distribution program in South Africa</title><author>Bassett, Ingrid V. ; Yan, Joyce ; Govere, Sabina ; Khumalo, Anele ; Ngobese, Nompumelelo ; Shazi, Zinhle ; Nzuza, Mpilonhle ; Bunda, Bridget A. ; Wara, Nafisa J. ; Stuckwisch, Ashley ; Zionts, Dani ; Dube, Nduduzo ; Tshabalala, Sandile ; Bogart, Laura M. ; Parker, Robert A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4487-c126381d0b6f2ab32bd127dffb952dcf9339a23dc4f35ac5b20e5c839d9d41123</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Acquired immune deficiency syndrome</topic><topic>Adult</topic><topic>Africa</topic><topic>AIDS</topic><topic>Ambulatory Care Facilities</topic><topic>Antiretroviral agents</topic><topic>Antiretroviral drugs</topic><topic>ARV</topic><topic>Chronic illnesses</topic><topic>Clinics</topic><topic>Cohort analysis</topic><topic>Cohort Studies</topic><topic>community</topic><topic>Cost control</topic><topic>differentiated care</topic><topic>Drug therapy</topic><topic>Female</topic><topic>Health care policy</topic><topic>HIV</topic><topic>HIV care continuum</topic><topic>HIV Infections - drug therapy</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Male</topic><topic>Mental health</topic><topic>Patients</topic><topic>Public sector</topic><topic>Short Report</topic><topic>Social support</topic><topic>South Africa</topic><topic>Stigma</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bassett, Ingrid V.</creatorcontrib><creatorcontrib>Yan, Joyce</creatorcontrib><creatorcontrib>Govere, Sabina</creatorcontrib><creatorcontrib>Khumalo, Anele</creatorcontrib><creatorcontrib>Ngobese, Nompumelelo</creatorcontrib><creatorcontrib>Shazi, Zinhle</creatorcontrib><creatorcontrib>Nzuza, Mpilonhle</creatorcontrib><creatorcontrib>Bunda, Bridget A.</creatorcontrib><creatorcontrib>Wara, Nafisa J.</creatorcontrib><creatorcontrib>Stuckwisch, Ashley</creatorcontrib><creatorcontrib>Zionts, Dani</creatorcontrib><creatorcontrib>Dube, Nduduzo</creatorcontrib><creatorcontrib>Tshabalala, Sandile</creatorcontrib><creatorcontrib>Bogart, Laura M.</creatorcontrib><creatorcontrib>Parker, Robert A.</creatorcontrib><collection>Wiley Open Access</collection><collection>Wiley Online Library Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest_Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Coronavirus Research Database</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of the International AIDS Society</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bassett, Ingrid V.</au><au>Yan, Joyce</au><au>Govere, Sabina</au><au>Khumalo, Anele</au><au>Ngobese, Nompumelelo</au><au>Shazi, Zinhle</au><au>Nzuza, Mpilonhle</au><au>Bunda, Bridget A.</au><au>Wara, Nafisa J.</au><au>Stuckwisch, Ashley</au><au>Zionts, Dani</au><au>Dube, Nduduzo</au><au>Tshabalala, Sandile</au><au>Bogart, Laura M.</au><au>Parker, Robert A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Uptake of community‐ versus clinic‐based antiretroviral therapy dispensing in the Central Chronic Medication Dispensing and Distribution program in South Africa</atitle><jtitle>Journal of the International AIDS Society</jtitle><addtitle>J Int AIDS Soc</addtitle><date>2022-01</date><risdate>2022</risdate><volume>25</volume><issue>1</issue><spage>e25877</spage><epage>n/a</epage><pages>e25877-n/a</pages><issn>1758-2652</issn><eissn>1758-2652</eissn><abstract>Introduction
South Africa's government‐led Central Chronic Medication Dispensing and Distribution (CCMDD) program offers people living with HIV the option to collect antiretroviral therapy at their choice of community‐ or clinic‐based pick‐up points intended to increase convenience and decongest clinics. To understand CCMDD pick‐up point use among people living with HIV, we evaluated factors associated with uptake of a community‐ versus clinic‐based pick‐up point at CCMDD enrolment.
Methods
We collected baseline data from October 2018 to March 2020 on adults (≥18 years) who met CCMDD clinical eligibility criteria (non‐pregnant, on antiretroviral therapy for ≥1 year and virologically suppressed) as part of an observational cohort in seven public clinics in KwaZulu‐Natal. We identified factors associated with community‐based pick‐up point uptake and fit a multivariable logistic regression model, including age, gender, employment status, self‐perceived barriers to care, self‐efficacy, HIV‐related discrimination, and perceived benefits and challenges of CCMDD.
Results and Discussion
Among 1521 participants, 67% were females, with median age 36 years (IQR 30–44). Uptake of a community‐based pick‐up point was associated with younger age (aOR 1.18 per 10‐year decrease, 95% CI 1.05–1.33), being employed ≥40 hours per week (aOR 1.42, 95% CI 1.10–1.83) versus being unemployed, no self‐perceived barriers to care (aOR 1.42, 95% CI 1.09–1.86) and scoring between 36 and 39 (aOR 1.44, 95% CI 1.03–2.01) or 40 (aOR 1.91, 95% CI 1.39–2.63) versus 10–35 on the self‐efficacy scale, where higher scores indicate greater self‐efficacy. Additional factors included more convenient pick‐up point location (aOR 2.32, 95% CI 1.77–3.04) or hours (aOR 5.09, 95% CI 3.71–6.98) as perceived benefits of CCMDD, and lack of in‐clinic follow‐up after a missed collection date as a perceived challenge of CCMDD (aOR 4.37, 95% CI 2.30–8.31).
Conclusions
Uptake of community‐based pick‐up was associated with younger age, full‐time employment, and systemic and structural factors of living with HIV (no self‐perceived barriers to care and high self‐efficacy), as well as perceptions of CCMDD (convenient pick‐up point location and hours, lack of in‐clinic follow‐up). Strategies to facilitate community‐based pick‐up point uptake should be tailored to patients’ age, employment, self‐perceived barriers to care and self‐efficacy to maximize the impact of CCMDD in decongesting clinics.</abstract><cop>Switzerland</cop><pub>John Wiley & Sons, Inc</pub><pmid>35077611</pmid><doi>10.1002/jia2.25877</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-6920-6080</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of the International AIDS Society, 2022-01, Vol.25 (1), p.e25877-n/a |
| issn | 1758-2652 1758-2652 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8789242 |
| source | Publicly Available Content Database; Wiley Open Access; PubMed Central; Coronavirus Research Database |
| subjects | Acquired immune deficiency syndrome Adult Africa AIDS Ambulatory Care Facilities Antiretroviral agents Antiretroviral drugs ARV Chronic illnesses Clinics Cohort analysis Cohort Studies community Cost control differentiated care Drug therapy Female Health care policy HIV HIV care continuum HIV Infections - drug therapy Human immunodeficiency virus Humans Male Mental health Patients Public sector Short Report Social support South Africa Stigma |
| title | Uptake of community‐ versus clinic‐based antiretroviral therapy dispensing in the Central Chronic Medication Dispensing and Distribution program in South Africa |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-11-11T13%3A43%3A31IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Uptake%20of%20community%E2%80%90%20versus%20clinic%E2%80%90based%20antiretroviral%20therapy%20dispensing%20in%20the%20Central%20Chronic%20Medication%20Dispensing%20and%20Distribution%20program%20in%20South%20Africa&rft.jtitle=Journal%20of%20the%20International%20AIDS%20Society&rft.au=Bassett,%20Ingrid%20V.&rft.date=2022-01&rft.volume=25&rft.issue=1&rft.spage=e25877&rft.epage=n/a&rft.pages=e25877-n/a&rft.issn=1758-2652&rft.eissn=1758-2652&rft_id=info:doi/10.1002/jia2.25877&rft_dat=%3Cproquest_pubme%3E2622964193%3C/proquest_pubme%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c4487-c126381d0b6f2ab32bd127dffb952dcf9339a23dc4f35ac5b20e5c839d9d41123%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2622923426&rft_id=info:pmid/35077611&rfr_iscdi=true |