ArticleAIDS research and therapy2015
Community-based ART distribution system can effectively facilitate long-term program retention and low-rates of death and virologic failure in rural Uganda.
Article in AIDS research and therapy, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04766710 (Implementation and Evaluation of a Community-Based Model for Delivery of Antiretroviral Therapy in Cambodia), which is not on this map. Cited by 61 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Implementation and Evaluation of a Community-Based Model for Delivery of Antiretroviral Therapy in Cambodia: A Quasi-Experimental Study
Who cites it
61 citing papers in PubMed, 2 syntheses or guidelines pooled it, 94 citations in OpenAlex.
- The HIV care cascade in sub-Saharan Africa: systematic review of published criteria and definitions.Journal of the International AIDS Society · 2021Pooled it
- Pooled it
- How community ART delivery may improve HIV treatment outcomes: Qualitative inquiry into mechanisms of effect in a randomized trial of community-based ART initiation, monitoring and re-supply (DO ART) in South Africa and Uganda.Journal of the International AIDS Society · 2021Trial
- Viral load care of HIV-1 infected children and adolescents: A longitudinal study in rural Zimbabwe.PloS one · 2021Trial
- Results from a proactive follow-up intervention to improve linkage and retention among people living with HIV in Uganda: a pre-/post- study.BMC health services research · 2018Trial
- Costs of streamlined HIV care delivery in rural Ugandan and Kenyan clinics in the SEARCH Studys.AIDS (London, England) · 2018Trial
- Trial
- Co-Occurring Risk Factors for Tuberculosis Preventive Treatment Non-Adherence Among People Living With HIV in Ethiopia: A Latent Class Analysis.Tropical medicine & international health : TM & IH · 2026Article
- Viral suppression and continued participation in the Community Retail Pharmacy Drug Distribution Point model among people living with HIV in Uganda.BMC health services research · 2025Article
- Evaluation of differentiated service delivery models on HIV treatment retention among key populations in Nigeria: a prospective cohort analysis.BMC public health · 2025Article
- Factors associated with completion of intensive adherence counseling among people living with HIV at a large referral hospital in Uganda: a retrospective analysis.BMC health services research · 2024Article
- Continuity of care during severe civil unrest with a model of community-based HIV care: a retrospective cohort study from Haiti.Lancet regional health. Americas · 2024Article
- HIV epidemiologic trends among occupational groups in Rakai, Uganda: A population-based longitudinal study, 1999-2016.PLOS global public health · 2024Article
- Sustained Retention, Viral Load Suppression and their Determinants Among Clients on HAART Enrolled Under Differentiated Service Delivery Models in Eastern Uganda.Research square · 2023Article
- Framework for determining the optimal course of action when efficiency and affordability measures differ by perspective in cost-effectiveness analysis-with an illustrative case of HIV treatment in Mozambique.Cost effectiveness and resource allocation : C/E · 2023Article
- Use of a context-specific package to increase sputum smear monitoring among people with pulmonary tuberculosis in Uganda: a quality improvement study.BMJ open quality · 2023Article
- Facility-led community based approach in Mamfe health district, Cameroon: a differentiated service delivery option in complex humanitarian settings.BMC health services research · 2023Article
- Article
- Opportunities and considerations for the design of decentralized delivery of antiretroviral therapy for female sex workers living with HIV in South Africa.BMC health services research · 2022Article
- Beyond viral suppression: Quality of life among stable ART clients in a differentiated service delivery intervention in Tanzania.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2022Article
1 more citing papers are in PubMed but not listed here.
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Authors and funding
13 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCommunity-drug distribution point is a care model for stable patients in the community designed to make ART delivery more efficient for the health system and provide appropriate support to encourage long-term retention of patients. We examined program retention among ART program participants in rural Uganda, which has used a community-based distribution model of ART delivery since 2004.
methodsWe analyzed data of all patients >18 years who initiated ART in Jinja, Ugandan site of The AIDS Support Organization between January 1, 2004 and July 31, 2009. Participants attended clinic or outreach visits every 2-3 months and had CD4 cell counts measured every 6 months. Retention to care was defined as any patient with at least one visit in the 6 months before June 1, 2013. We then identified participants with at least one visit in the 6 months before June 1, 2013 and examined associations with mortality and lost-to-follow-up (LTFU). Participants with >4 years of follow up during August, 2012 to May, 2013 had viral load conducted, since no routine viral load testing was available.
resultsA total of 3345 participants began ART during 2004-2009. The median time on ART in June 2013 was 5.69 years. A total of 1335 (40 %) were residents of Jinja district and 2005 (60 %) resided in outlying districts. Of these, 2322 (69 %) were retained in care, 577 (17 %) died, 161 (5 %) transferred out and 285 (9 %) were LTFU. Factors associated with mortality or LTFU included male gender, [Adjusted Hazard Ratio (AHR) = 1.56; 95 % CI 1.28-1.9], CD4 cell count <50 cells/μL (AHR = 4.09; 95 % CI 3.13-5.36) or 50-199 cells/μL (AHR = 1.86; 95 % CI 1.46-2.37); ART initiation and WHO stages 3 (AHR = 1.35; 95 % CI 1.1-1.66) or 4 (AHR = 1.74; 95 % CI 1.23-2.45). Residence outside of Jinja district was not associated with mortality/LTFU (p value = 0.562). Of 870 participants who had VL tests, 756 (87 %) had VLs <50 copies/mL.
conclusionCommunity-based ART distribution systems can effectively mitigate the barriers to program retention and result in good rates of virologic suppression.
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