{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T04:25:16Z","timestamp":1787891116920,"version":"build-2784847793"},"reference-count":24,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2019,8,27]],"date-time":"2019-08-27T00:00:00Z","timestamp":1566864000000},"content-version":"vor","delay-in-days":26,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Intern AIDS Soc"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Community ART Refill Groups (CARGs) are an antiretroviral therapy (ART) delivery model where clients voluntarily form into groups, and a group member visits the clinic to collect ART for all group members. In late 2016, Zimbabwe began a nationwide rollout of the CARG model. We conducted a qualitative evaluation to assess the perceived effects of this new national service delivery model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In March\u2010June 2018, we visited ten clinics implementing the CARG model across five provinces of Zimbabwe and conducted a focus group discussion with healthcare workers and in\u2010depth interviews with three ART clients per clinic. Clinics had implemented the CARG model for approximately one year. All discussions were audio recorded, transcribed, and translated into English, and thematic coding was performed by two independent analysts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In focus groups, healthcare workers described that CARGs made ART distribution faster and facilitated client tracking in the community. They explained that their reduced workload allowed them to provide better care to those clients who did visit the clinic, and they felt that the CARG model should be sustained in the future. CARG members reported that by decreasing the frequency of clinic visits, CARGs saved them time and money, reducing previous barriers to collecting ART and improving adherence. CARG members also valued the emotional and informational support that they received from other members of their CARG, further improving adherence. Multiple healthcare workers did express concern that CARG members with diseases that begin with minor symptoms, such as tuberculosis, may not seek treatment at the clinic until the disease has progressed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We found that healthcare workers and clients overwhelmingly perceive CARGs as beneficial. This evaluation demonstrates that the CARG model can be successfully implemented on a national scale. These early results suggest that CARGs may be able to simultaneously improve clinical outcomes and reduce the workload of healthcare workers distributing ART.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25393","type":"journal-article","created":{"date-parts":[[2019,8,27]],"date-time":"2019-08-27T15:00:00Z","timestamp":1566918000000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["The rollout of Community ART Refill Groups in Zimbabwe: a qualitative evaluation"],"prefix":"10.1002","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8348-3375","authenticated-orcid":false,"given":"Aaron F","family":"Bochner","sequence":"first","affiliation":[{"name":"International Training and Education Center for Health (I\u2010TECH) Department of Global Health University of Washington Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Meacham","sequence":"additional","affiliation":[{"name":"International Training and Education Center for Health (I\u2010TECH) Department of Global Health University of Washington Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan","family":"Mhungu","sequence":"additional","affiliation":[{"name":"International Training and Education Center for Health (I\u2010TECH) Harare Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phibion","family":"Manyanga","sequence":"additional","affiliation":[{"name":"International Training and Education Center for Health (I\u2010TECH) Harare Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frances","family":"Petracca","sequence":"additional","affiliation":[{"name":"International Training and Education Center for Health (I\u2010TECH) Department of Global Health University of Washington Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudios","family":"Muserere","sequence":"additional","affiliation":[{"name":"International Training and Education Center for Health (I\u2010TECH) Harare Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gloria","family":"Gonese","sequence":"additional","affiliation":[{"name":"International Training and Education Center for Health (I\u2010TECH) Harare Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Batsirai","family":"Makunike","sequence":"additional","affiliation":[{"name":"International Training and Education Center for Health (I\u2010TECH) Harare Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blessing","family":"Wazara","sequence":"additional","affiliation":[{"name":"International Training and Education Center for Health (I\u2010TECH) Harare Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clorata","family":"Gwanzura","sequence":"additional","affiliation":[{"name":"Ministry of Health and Child Care Harare Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ponesai","family":"Nyika","sequence":"additional","affiliation":[{"name":"U.S. Centers for Disease Control and Prevention Harare Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth","family":"Levine","sequence":"additional","affiliation":[{"name":"International Training and Education Center for Health (I\u2010TECH) Department of Global Health University of Washington Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsitsi","family":"Mutasa\u2010Apollo","sequence":"additional","affiliation":[{"name":"Ministry of Health and Child Care Harare Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shirish","family":"Balachandra","sequence":"additional","affiliation":[{"name":"U.S. Centers for Disease Control and Prevention Harare Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan Z","family":"Wiktor","sequence":"additional","affiliation":[{"name":"International Training and Education Center for Health (I\u2010TECH) Department of Global Health University of Washington Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,8,27]]},"reference":[{"key":"e_1_2_9_2_1","volume-title":"Fast\u2010Track \u2010 Ending the AIDS Epidemic by 2030","author":"UNAIDS","year":"2014"},{"key":"e_1_2_9_3_1","volume-title":"Adherence guidelines for HIV, TB and NCDs: policy and service delivery guidelines for linkage to care, adherence to treatment and retention in care","author":"South African Department of Health","year":"2016"},{"key":"e_1_2_9_4_1","unstructured":"Kenya Ministry of Health National AIDS & STI Control Program.Differentiated care: operational guide. 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