"I do understand why counselling is poor in the facilities because the nurses are overwhelmed. Effective counselling is not about numbers – I'm not a number, I'm a human being. The focus should be on the quality of service I receive. If we can shift the stable clients, it means there will be enough time for counselling the person who is unwell."

Vusi Matsebula, PLHIV, Swaziland

Stable client models

Recent innovations in ART delivery, or differentiated service delivery (DSD) for people established on HIV treatment, can be categorized into four models. Within these models, all clients continue to have clinical consultations as part of their package of care. Multiple models can work in parallel so that a client can move between them during the course of their lifetime. Further, the models are flexible to accommodate clients who may want to or require up-referral. By being up-referred, the intensity of care is increased to reflect the increased clinical needs of the client.

Watch these explainer videos outlining the standard operating procedures (SOPs) for the four common models for DSD for HIV treatment and common adaptations for specific populations.