Differentiated Antiretroviral Therapy Delivery: Implementation Barriers and Enablers in South Africa. (September 2019)

• Record Type: Journal Article
• Authors: Sharer, Melissa; Davis, Nicole; Makina, Ndinda; Duffy, Malia; Eagan, Sabrina
• Is Part Of: Journal of the Association of Nurses in AIDS Care. Volume 30:Number 5(2019)
• Page Start: 511
• Page End: 520
• Publication Date: 2019-09
• Subjects: antiretroviral therapy differentiation -- community ART programs -- HIV treatment -- South Africa -- stigma; AIDS (Disease) -- Nursing -- Periodicals; AIDS (Disease) -- Treatment -- Periodicals; AIDS (Disease) -- Periodicals; HIV infections -- Nursing -- Periodicals; HIV infections -- Treatment -- Periodicals; HIV infections -- Periodicals; 616.97920231
• DOI: 10.1097/JNC.0000000000000062
• Languages: English
• ISSNs: 1055-3290

Abstract

Abstract: Scale-up of antiretroviral therapy (ART) for people living with HIV requires differentiated models of ART delivery to improve access and contribute to achieving viral suppression for 95% of people on ART. We examined barriers and enablers in South Africa via semistructured interviews with 33 respondents (program implementers, nurses, and other health care providers) from 11 organizations. The interviews were recorded, transcribed, and analyzed for emerging themes using NVivo 11 software. Major enablers of ART delivery included model flexibility, provision of standardized guidance, and an increased focus on person-centered care. Major barriers were related to financial, human, and space resources and the need for time to allow buy-in. Stigma emerged as both a barrier and an enabler. Findings suggest that creating and strengthening models that cater to client needs can achieve better health outcomes. South Africa's efforts can inform emerging models in other settings to achieve epidemic control.