{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,8]],"date-time":"2026-08-08T21:49:01Z","timestamp":1786225741676,"version":"build-2736575974"},"reference-count":32,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,3,31]],"date-time":"2021-03-31T00:00:00Z","timestamp":1617148800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000200","name":"United States Agency for International Development","doi-asserted-by":"publisher","award":["AID\u2010OAA\u2010A\u201014\u20100045"],"award-info":[{"award-number":["AID\u2010OAA\u2010A\u201014\u20100045"]}],"id":[{"id":"10.13039\/100000200","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J. Intern. AIDS Soc."],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Differentiated service delivery (DSD) for antiretroviral therapy (ART) maintenance embodies the client\u2010centred approach to tailor services to support people living with HIV in adhering to treatment and achieving viral suppression. We aimed to assess the preferences for HIV care and attitudes towards DSD for ART maintenance among ART clients and providers at healthcare facilities in Thailand.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cross\u2010sectional study using self\u2010administered questionnaires was conducted in September\u2010November 2018 at five healthcare facilities in four high HIV burden provinces in Thailand. Eligible participants who were ART clients aged \u226518\u00a0years and ART providers were recruited by consecutive sampling. Descriptive statistics were used to summarize demographic characteristics, preferences for HIV services and expectations and concerns towards DSD for ART maintenance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Five hundred clients and 52 providers completed the questionnaires. Their median ages (interquartile range; IQR) were 38.6 (29.8 to 45.5) and 37.3 (27.3 to 45.1); 48.5% and 78.9% were females, 16.8% and 1.9% were men who have sex with men, and 2.4% and 7.7% were transgender women, respectively. Most clients and providers agreed that ART maintenance tasks, including ART refill, viral load testing, HIV\/sexually transmitted infection monitoring, and psychosocial support should be provided at ART clinics (85.2% to 90.8% vs. 76.9% to 84.6%), by physicians (77.0% to 94.6% vs. 71.2% to 100.0%), every three months (26.7% to 40.8% vs. 17.3% to 55.8%) or six months (33.0% to 56.7% vs. 28.9% to 80.8%). Clients agreed that DSD would encourage their autonomy (84.9%) and empower responsibility for their health (87.7%). Some clients and providers disagreed that DSD would lead to poor ART retention (54.0% vs. 40.4%), increased loss to follow\u2010up (52.5% vs. 42.3%), and delayed detection of treatment failure (48.3% vs. 44.2%), whereas 31.4% to 50.0% of providers were unsure about these expectations and concerns.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Physician\u2010led, facility\u2010based clinical consultation visit spacing in combination with multi\u2010month ART refill was identified as one promising DSD model in Thailand. However, low preference for decentralization and task shifting may prove challenging to implement other models, especially since many providers were unsure about DSD benefits. This calls for local implementation studies to prove feasibility and governmental and social support to legitimize and normalize DSD in order to gain acceptance among clients and providers.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25693","type":"journal-article","created":{"date-parts":[[2021,4,1]],"date-time":"2021-04-01T05:21:54Z","timestamp":1617254514000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Client and provider preferences for HIV care: Implications for implementing differentiated service delivery in Thailand"],"prefix":"10.1002","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5380-2013","authenticated-orcid":false,"given":"Sita","family":"Lujintanon","sequence":"first","affiliation":[{"name":"Institute of HIV Research and Innovation Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sorawit","family":"Amatavete","sequence":"additional","affiliation":[{"name":"Institute of HIV Research and Innovation Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thanthip","family":"Sungsing","sequence":"additional","affiliation":[{"name":"Institute of HIV Research and Innovation Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3941-3457","authenticated-orcid":false,"given":"Pich","family":"Seekaew","sequence":"additional","affiliation":[{"name":"Institute of HIV Research and Innovation Bangkok Thailand"},{"name":"Department of Epidemiology Columbia University Mailman School of Public Health New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jitsupa","family":"Peelay","sequence":"additional","affiliation":[{"name":"Institute of HIV Research and Innovation Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pravit","family":"Mingkwanrungruang","sequence":"additional","affiliation":[{"name":"Institute of HIV Research and Innovation Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6053-9436","authenticated-orcid":false,"given":"Tanat","family":"Chinbunchorn","sequence":"additional","affiliation":[{"name":"Institute of HIV Research and Innovation Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Somsong","family":"Teeratakulpisarn","sequence":"additional","affiliation":[{"name":"Thai Red Cross AIDS Research Centre Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pornpen","family":"Methajittiphan","sequence":"additional","affiliation":[{"name":"Queen Savang Vadhana Memorial Hospital Chonburi Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prattana","family":"Leenasirima","sequence":"additional","affiliation":[{"name":"Nakornping Hospital Chiang Mai Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amarin","family":"Norchaiwong","sequence":"additional","affiliation":[{"name":"Sarapee Hospital Chiang Mai Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ampaipith","family":"Nilmanat","sequence":"additional","affiliation":[{"name":"Hatyai Hospital Songkhla Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Praphan","family":"Phanuphak","sequence":"additional","affiliation":[{"name":"Institute of HIV Research and Innovation Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6293-9422","authenticated-orcid":false,"given":"Reshmie A","family":"Ramautarsing","sequence":"additional","affiliation":[{"name":"Institute of HIV Research and Innovation Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0036-3165","authenticated-orcid":false,"given":"Nittaya","family":"Phanuphak","sequence":"additional","affiliation":[{"name":"Institute of HIV Research and Innovation Bangkok Thailand"},{"name":"Center of Excellence in Transgender Health Chulalongkorn University Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,3,31]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"Fast\u2010track ending the AIDS epidemic by 2030. 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