{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T19:01:06Z","timestamp":1790794866323,"version":"4.1.0"},"reference-count":74,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,6,9]],"date-time":"2021-06-09T00:00:00Z","timestamp":1623196800000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["INV02610"],"award-info":[{"award-number":["INV02610"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>In response to COVID\u201019, national ministries of health adapted HIV service delivery guidelines to ensure uninterrupted access to antiretroviral therapy (ART) and limit the frequency of contact with health facilities. In this commentary, we summarize four ways in which differentiated service delivery (DSD) for HIV treatment has been accelerated during COVID\u201019 in policy and implementation in sub\u2010Saharan Africa (SSA) \u2013 (i) expanding eligibility for DSD for HIV treatment, (ii) extending multi\u2010month dispensing (MMD) and reducing the frequency of clinical consultations, (iii) emphasizing community\u2010based models and (iv) integrating\/aligning with TB preventative therapy (TPT), non\u2010communicable disease (NCD) treatments and family planning commodities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Across SSA in 2020, countries both adapted and emphasized policies supporting DSD for HIV treatment in response to COVID\u201019. Access to DSD for HIV treatment was expanded by reducing the time required on ART before eligibility and being more inclusive of specific populations including children and adolescents, pregnant and breastfeeding women and those on second\u2010 and third\u2010line regimens. Access to extended ART refills, or MMD, was accelerated across many countries. A renewed focus was given to out\u2010of\u2010facility community\u2010based models of ART distribution. In some settings, there was acknowledgement of the need to integrate or align other chronic medications with ART.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Adaptations to DSD for HIV treatment in response to COVID\u201019 have resulted in rapid policy change and in some cases, acceleration of implementation in SSA. As the COVID\u201019 pandemic evolves, there is a critical need to assess the impact of these adaptations and, where beneficial, ensure that policies implemented in response to COVID\u201019 become the new normal.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25704","type":"journal-article","created":{"date-parts":[[2021,6,9]],"date-time":"2021-06-09T13:58:16Z","timestamp":1623247096000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":90,"title":["Acceleration of differentiated service delivery for HIV treatment in sub\u2010Saharan Africa during COVID\u201019"],"prefix":"10.1002","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1199-8377","authenticated-orcid":false,"given":"Anna","family":"Grimsrud","sequence":"first","affiliation":[{"name":"HIV Programmes and Advocacy International AIDS Society Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynne","family":"Wilkinson","sequence":"additional","affiliation":[{"name":"HIV Programmes and Advocacy International AIDS Society Cape Town South Africa"},{"name":"Centre for Infectious Disease Epidemiology and Research University of Cape Town Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,6,9]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"UNAIDS.Prevailing against pandemics by putting people at the centre \u2014 World AIDS Day report 2020.2020[cited 2021 Jan 13]. 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