Improving Patient Antiretroviral Therapy Retention through Community Adherence Groups in Zambia

Description/Activities: CIDRZ provides multi-month drug dispensing (3 months’ supply of ART) for each of the patients participating in the CAGs. Each CAG has 6 patients, who take turns visiting the ART clinic for clinical consultation and antiretroviral (ARV) drug collection. Annually, each patient has two clinical visits and will return to the clinic for their clinical follow-up appointment, even if it is not their turn to collect medications. Each CAG is assigned a community health worker (CHW) who provides basic psycho-social and clinical support to the CAG members. Index testing through family and partner notification has also been implemented through the CAGs.

What Makes the Intervention Unique/Different: Addresses the concern of convenience – making it more convenient for patients to pick up their ARVs from a community-level distribution group rather than having to go to the clinic.  Also decongests the facility by offering differentiated pick-up points for drug distribution.

Impact Data: Impact Data

  • 856 CAGs have been formed, with 4,876 patients across 5 districts participating in these groups. 
  • 4,375 people were tested for HIV through index testing and of those, 540 tested positive representing a 12 % yield, with 100% of clients linked to treatment.
  • ART retention is 97%, compared to 76% retention in patients at the health-facility level; high linkage to treatment for those testing positive through index testing methods; high patient satisfaction, as ARVs are collected in the community at a time convenient to patients; and decongestion and reduced waiting times at ART clinics.