Assessment of differentiated models of care for stable patients on antiretroviral therapy in a tertiary health facility in Southwestern Nigeria

Abstract

Objectives: Differentiated care is a patient-centered care designed to improve quality of antiretroviral therapy (ART) service delivery. However, documenting patient experiences on models of differentiated care are critical to understanding and improving the models. This study assessed the preferences of patients on ART for differentiated care models and also explored the experiences of patients with the models. Materials and Methods: An in-depth interview was conducted on 30 patients on differentiated care models. Interviews were audio recorded, later transcribed, and combined with notes taken during the interview. Themes around preference for models, benefits, and challenges associated with models and subthemes were developed from the codes, verified, and analyzed using content analysis. Atlasti version 8 was used to code and develop themes from the data collected. Results: Participants expressed preferences for fast track model which is a facility-based model. They also reported that models yielded key benefits including reduced waiting time and cost of accessing drugs. The major negative impact reported by participants in community-based model was increased status disclosure risk and instability of program in the community pharmacies. Conclusion: Study participants living with human immunodeficiency virus and acquired immunodeficiency syndrome on differentiated care preferred facility-based models. Program instability and increased risk of status disclosure were major challenges associated with community-based model.