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    Apr 12, 2021
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    Reframing HIV Care: Putting People at the Centre of Antiretroviral Delivery

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    Name:
    Duncome C et al - 2015 - Reframing ...
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    Authors
    Duncombe, Chris
    Rosenblum, Scott
    Hellmann, Nicholas
    Holmes, Charles
    Wilkinson, Lynne
    Biot, Marc
    Bygrave, Helen
    Hoos, David
    Garnett, Geoff
    Issue Date
    2015-01-13
    
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    Journal
    Tropical Medicine & International Health
    Abstract
    The delivery of HIV care in the initial rapid scale-up of HIV care and treatment was based on existing clinic-based models, which are common in highly resourced settings and largely undifferentiated for individual needs. A new framework for treatment based on variable intensities of care tailored to the specific needs of different groups of individuals across the cascade of care is proposed here. Service intensity is characterized by four delivery components: (1) types of services delivered, (2) location of service delivery, (3) provider of health services, and (4) frequency of health services. How these components are developed into a service delivery framework will vary across countries and populations, with the intention being to improve acceptability and care outcomes. The goal of getting more people on treatment before they become ill will necessitate innovative models of delivering both testing and care. As HIV programs expand treatment eligibility, many people entering care will not be "patients" but healthy, active and productive members of society.(1) In order to take the framework to scale, it will be important to: (1) define which individuals can be served by an alternative delivery framework; (2) strengthen health systems that support decentralization, integration and task shifting; (3) make the supply chain more robust; and (4) invest in data systems for patient tracking and for program monitoring and evaluation. This article is protected by copyright. All rights reserved.
    Publisher
    Wiley-Blackwell
    URI
    http://hdl.handle.net/10144/338918
    DOI
    10.1111/tmi.12460
    PubMed ID
    25583302
    Language
    en
    ISSN
    1365-3156
    ae974a485f413a2113503eed53cd6c53
    10.1111/tmi.12460
    Scopus Count
    Collections
    HIV/AIDS

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