Improving Access to HIV Treatment Services through Community Antiretroviral Therapy Distribution Points in Uganda

Description/Activities:  ART care and treatment is delivered to consenting, stable patients at a pre-identified, community-based site, called a “community drug distribution point (CDDP).”  Eligible clients receive a 2-month supply of ART and a follow-up appointment at the CDDP for continued care. Core services provided at the CDDP by TASO staff in collaboration with expert patients include: refills every two to three months, assessment of clinical status by the clinical team every 6 months, psychosocial support by expert clients, and clinical services such as TB screening, weight measurement, and lab tests.

What Makes the Intervention Unique/Different: The program is client centric and brings the medicines closer to the patient, rather than making the patient go to pick up their medicines from facilities; delivers ARTs to the community. Each CDDP is a linked to a health facility and is coordinated and supported by a health care worker from that facility. Patients are recruited voluntarily from health facilities and are seen every 6 months. Attendance registers document drug pickup at the CDDP and flag patients who do not attend.

As of September 2017, approximately 80,000 patients on ART, which is about two-thirds of the ART patients supported by TASO, receive their medications through the CDDP model. Here are some of the noted impacts:

  • Shorter wait times for ART refills at pharmacies linked to CDDPs – from 2-3 hours to 30-45 minutes.
  • Reduced travel time and costs for patients by providing ART refills closer to their homes.
  • 98% ART retention for patients at CDDPs. While this is a higher rate than among patients at TASO-supported sites overall (71%), it is important to note that CDDPs only enroll stable, adherent patients.
  • An estimated 5-10% of patients are re-referred to their health facility at some point. Viral suppression testing is being introduced nationwide, though it has not yet achieved sufficient scale for analysis