Differentiated Service Delivery for Adults at High Risk of HIV Disease Progression

A Call to Action

In recent years, the evidence base for differentiated service delivery (DSD) for stable patients has grown, while there has been less attention to developing differentiated models of care for patients with advanced or unstable HIV disease. Clinical guidelines and policies regarding optimal packages of care for high-risk patients exist, but most suggest (or imply) that these services should be delivered as per usual facility-based models. They give few or no recommendations about how, by whom, or where they should be delivered for optimal impact. Little evidence exists on optimal programmatic models for high-risk patients to identify best practices and resources for the how of differentiated HIV services for these populations. This suggests a need for innovative thinking and pilot projects designed to optimize program design for such patients.

The Big Picture

ICAP convened an international technical working group to review the evidence base on DSD for patients at high risk, and to make recommendations about options and priorities moving forward. CQUIN’s Call to Action document defines the target populations of interest, describes recommended packages of care, and reviews available DSD models. This document is intended to motivate stakeholders to share their experiences, generate new evidence, and to advocate for attention to this high-risk population.

This project is linked to CQUIN’s Community of Practice for DSD for patients at high risk of HIV disease progression, and will inform subsequent workshops and joint-learning activities.

For more information on CQUIN’s Call to Action, contact Peter Preko at pp2332@cumc.columbia.edu.