A wide range of published evidence relating to differentiated service delivery is available. A summary of published evidence for differentiated ART delivery along with links to the publications is available here. The content below has been grouped thematically and includes other published literature such as commentaries, country implementation, costing studies and more.  

Commentaries, editorials and viewpoints

Grimsrud, A. and Wilkinson, L. Acceleration of differentiated service delivery for HIV treatment in sub-Saharan Africa during COVID-19. J Int AIDS Soc. 2021; 24(6):e25704 

Collins LF, Colasanti JA, Nguyen ML, Moran CA, Lahiri CD, Marconi VC et al.  The COVID-19 pandemic as a catalyst for differentiated care models to end the HIV epidemic in the U.S. - applying lessons from high-burden settings. AIDS. 2020 Nov 5. doi: 10.1097/QAD.0000000000002746. Epub ahead of print. PMID: 33165032.

Ehrenkranz P, Grimsrud A, Holmes CB, Preko P, Rabkin M.  Expanding the vision for differentiated service delivery: a call for more inclusive and truly patient-centered care for people living with HIV.  J Acquir Immune Defic Syndr. 2020 Oct 23. doi:10.1097/QAI.0000000000002549. Epub ahead of print. PMID: 33136818.

Rosen S, Grimsrud A, Ehrenkranz P, Katz I. Models of service delivery for optimizing a patient's first six months on antiretroviral therapy for HIV: an applied research agenda. Gates Open Res. 2020 Jul 29;4:116. doi: 10.12688/gatesopenres.13159.1. PMID: 32875281; PMCID: PMC7445417.

Georgetown University The Policy Lab. Access During COVID-19: National Policies on Multi-month Supplies of HIV Medications.

Wilkinson L, Grimsrud A. The time is now: expedited HIV differentiated service delivery during the COVID-19 pandemic. J Int AIDS Soc. 2020;23(5):e25503.

Ford N, Geng E, Ellman T, Orrell C, Ehrenkranz P, Sikazwe I, et al. Emerging priorities for HIV service delivery. PLoS Med. 2020;17(2):e1003028.

Reidy WJ, Rabkin M, Syowai M, Schaaf A, El-Sadr WM. Patient-level and program-level monitoring and evaluation of differentiated service delivery for HIV: a pragmatic and parsimonious approach is needed. Aids. 2018;32(3):399-401.

Grimsrud A, Barnabas RV, Ehrenkranz P, Ford N. Evidence for scale up: the differentiated care fresearch agenda. J Int AIDS Soc. 2017;20(Suppl 4):22024.

Grimsrud A, Bygrave H, Doherty M, Ehrenkranz P, Ellman T, Ferris R, et al. Reimagining HIV service delivery: the role of differentiated care from prevention to suppression. J Int AIDS Soc. 2016;19(1):21484.

Campion EW. Treating millions for HIV--the adherence clubs of Khayelitsha. N Engl J Med. 2015;372(4):301-3.

Specific populations

Barnabas RV, Szpiro AA, van Rooyen H, Asiimwe S, Pillay D, Ware NC, et al. Community-based antiretroviral therapy versus standard clinic-based services for HIV in South Africa and Uganda (DO ART): a randomised trial. Lancet Glob Health. 2020;8(10):e1305-e15.

Wilkinson L, Siberry GK, Golin R, Phelps BR, Wolf HT, Modi S, et al. Children and their families are entitled to the benefits of differentiated ART delivery. J Int AIDS Soc. 2020;23(4):e25482.

Grimsrud AT, Pike C, Bekker LG. The power of peers and community in the continuum of HIV care. Lancet Glob Health. 2020;8(2):e167-e8.

Grimsrud A, Bygrave H, Wilkinson L. The Case For Family-Centered Differentiated Service Delivery for HIV. J Acquir Immune Defic Syndr. 2018;78 Suppl 2:S124-s7.

Reif LK, McNairy ML, Lamb MR, Fayorsey R, Elul B. Youth-friendly services and differentiated models of care are needed to improve outcomes for young people living with HIV. Curr Opin HIV AIDS. 2018;13(3):249-56.

Srivastava M, Sullivan D, Phelps BR, Modi S, Broyles LN. Boosting ART uptake and retention among HIV-infected pregnant and breastfeeding women and their infants: the promise of innovative service delivery models. J Int AIDS Soc. 2018;21(1).

Macdonald V, Verster A, Baggaley R. A call for differentiated approaches to delivering HIV services to key populations. J Int AIDS Soc. 2017;20(Suppl 4):21658.

Mirkovic KR, Rivadeneira ED, Broyles LN. Children and alternative service delivery models: a case for inclusion.  Aids. 30. England2016. p. 2569-70.

Beyond HIV

Liu L, Christie S, Munsamy M, Roberts P, Pillay M, Shenoi SV, et al. Title: Expansion of a national differentiated service delivery model to support people living with HIV and other chronic conditions in South Africa: a descriptive analysis. BMC Health Services Research. 2021;21:463. doi: 10.1186/s12913-021-06450-z. PubMed PMID: PMC8127180.

Roberts T, Sahu S, Malar J, Abdullaev T, Vandevelde W, Pillay YG, et al. Turning threats into opportunities: how to implement and advance quality TB services for people with HIV during the COVID-19 pandemic and beyond. Journal of the International AIDS Society. 2021;24(4):e25696.

Boyd AT, Moore B, Shah M, Tran C, Kirking H, Cavanaugh JSet al. Implementing TB preventive treatment within differentiated HIV service delivery models in global programs. Public Health Action. 2020 Sep 21;10(3):104-110. doi: 10.5588/pha.20.0014. PMID: 33134124; PMCID: PMC7577005.

Bygrave H, Golob L, Wilkinson L, Roberts T, Grimsrud A. Let's talk chronic disease: can differentiated service delivery address the syndemics of HIV, hypertension and diabetes? Curr Opin HIV AIDS. 2020;15(4):256-60.

Pathmanathan I, Pevzner E, Cavanaugh J, Nelson L. Addressing tuberculosis in differentiated care provision for people living with HIV.  Bull World Health Organ. 952017. p. 3.

Tram KH, Mwangwa F, Atukunda M, Owaraganise A, Ayieko J, Plenty A, et al. Isoniazid Preventive Therapy Completion in the Era of Differentiated HIV Care. J Acquir Immune Defic Syndr. 2017;76(5):e115-e7.

Geldsetzer P, Ortblad K, Bärnighausen T. The efficiency of chronic disease care in sub-Saharan Africa.  BMC Med. 142016. p. 127.

Costing and cost-effectiveness

Note: Costing studies for specific differentiated models of ART delivery are included within the evidence summaries here. Below are general costing studies related to differentiated service delivery.  

Okere, N. E., Corball, L., Kereto, D., Hermans, S., Naniche, D., Rinke de Wit, T. F. and Gomez, G. B. Patient-incurred costs in a differentiated service delivery club intervention compared to standard clinical care in Northwest Tanzania. J Int AIDS Soc. 2021; 24( 6):e25760

Nichols BE, Cele R, Lekodeba N, Tukei B, Ngorima-Mabhena N, Tiam A, et al. Economic evaluation of differentiated service delivery models for HIV treatment in Lesotho: costs to providers and patients. Journal of the International AIDS Society. 2021;24(4):e25692.

Hoffman RM, Moyo C, Balakasi KT, Siwale Z, Hubbard J, Bardon A, et al. Multimonth dispensing of up to 6 months of antiretroviral therapy in Malawi and Zambia (INTERVAL): a cluster-randomised, non-blinded, non-inferiority trial. The Lancet Global Health. 2021;9(5):e628-e38.

Nichols BE, Cele R, Jamieson L, Long LC, Siwale Z, Banda P et al. Community-based delivery of HIV treatment in Zambia: costs and outcomes. AIDS. 2020 Nov 5. doi: 10.1097/QAD.0000000000002737. Epub ahead of print. PMID: 33170578.

Larson BA, Pascoe SJ, Huber A, Long LC, Murphy J, Miot J, et al. Will differentiated care for stable HIV patients reduce healthcare systems costs? J Int AIDS Soc. 2020;23(7):e25541.

Forsythe S, Lee B, Tarimo K, Silvan B, Balampama M, Chitty J, et al. HIV treatment support services in Tanzania: a cost and efficiency analysis at facility and community levels. Afr J AIDS Res. 2019;18(4):306-14.

Roberts DA, Tan N, Limaye N, Irungu E, Barnabas RV. Cost of Differentiated HIV Antiretroviral Therapy Delivery Strategies in Sub-Saharan Africa: A Systematic Review. J Acquir Immune Defic Syndr. 2019;82 Suppl 3(Suppl 3):S339-s47.

Barker C, Dutta A, Klein K. Can differentiated care models solve the crisis in HIV treatment financing? Analysis of prospects for 38 countries in sub-Saharan Africa. J Int AIDS Soc. 2017;20(Suppl 4):21648.

Vaikath M, Khan S, Mafara E, Dlamini N, Dlamini P, Ndzinisa N, et al. Patient out of pocket expenditures for ART in Swaziland.  CROI2017; Seattle, USA2017.

Phillips AN, Cambiano V, Nakagawa F, Bansi-Matharu L, Sow PS, Ehrenkranz P, et al. Cost Effectiveness of Potential ART Adherence Monitoring Interventions in Sub-Saharan Africa. PLoS One. 2016;11(12):e0167654.

Phillips A, Shroufi A, Vojnov L, Cohn J, Roberts T, Ellman T, et al. Sustainable HIV treatment in Africa through viral-load-informed differentiated care. Nature. 2015;528(7580):S68-76.

Other publications including pre-prints (not peer-reviewed) and protocols (studies underway)

Ross J, Murenzi G, Hill S, Remera E, Ingabire C, Umwiza F, et al. Reducing time to differentiated service delivery for newly diagnosed people living with HIV in Kigali, Rwanda: study protocol for a pilot, unblinded, randomised controlled study. BMJ open. 2021;11(4):e047443-e. doi: 10.1136/bmjopen-2020-047443. PubMed PMID: 33895720.

Amstutz A, Lejone TI, Khesa L, Kopo M, Kao M, Muhairwe J, Bresser M, et al. Offering ART Refill Through Community Health Workers Versus Clinic-Based Follow-Up After Home-Based Same-Day ART Initiation: The VIBRA Cluster-Randomised Clinical Trial. 2021. Available at SSRN: https://ssrn.com/abstract=3824772 or http://dx.doi.org/10.2139/ssrn.3824772

Huber A, Pascoe S, Nichols BE, Long L, Kuchukhidze S, Phiri B, et al. Differentiated service delivery models for HIV treatment in Malawi, South Africa, and Zambia: A landscape analysis. medRxiv. 2020:2020.08.25.20181818.

Amstutz A, Lejone TI, Khesa L, Muhairwe J, Nsakala BL, Tlali K, et al. VIBRA trial - Effect of village-based refill of ART following home-based same-day ART initiation vs clinic-based ART refill on viral suppression among individuals living with HIV: protocol of a cluster-randomized clinical trial in rural Lesotho. Trials. 2019;20(1):522.

Hoffman R, Bardon A, Rosen S, Fox M, Kalua T, Xulu T, et al. Varying intervals of antiretroviral medication dispensing to improve outcomes for HIV patients (The INTERVAL Study): study protocol for a randomized controlled trial. Trials. 2017;18(1):476

Ssempijja V, Nason M, Nakigozi G, Ndyanabo A, Gray R, Wawer M, et al. Adaptive Viral Load Monitoring Frequency to Facilitate Differentiated Care: A Modeling Study From Rakai, Uganda. Clin Infect Dis. 2020;71(4):1017-21.

Ssonko C, Gonzalez L, Mesic A, da Fonseca MS, Achar J, Safar N, et al. Delivering HIV care in challenging operating environments: the MSF experience towards differentiated models of care for settings with multiple basic health care needs. J Int AIDS Soc. 2017;20(Suppl 4):21654.

Mutasa-Apollo T, Ford N, Wiens M, Socias ME, Negussie E, Wu P, et al. Effect of frequency of clinic visits and medication pick-up on antiretroviral treatment outcomes: a systematic literature review and meta-analysis. J Int AIDS Soc. 2017;20(Suppl 4):21647