{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T19:27:05Z","timestamp":1790710025736,"version":"4.1.0"},"reference-count":20,"publisher":"Wiley","issue":"S1","license":[{"start":{"date-parts":[[2023,7,6]],"date-time":"2023-07-06T00:00:00Z","timestamp":1688601600000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Non\u2010communicable diseases (NCDs) are highly prevalent in people living with HIV above 50 years of age and account for increasing mortality. There is little published evidence supporting person\u2010centred, integrated models of HIV care, hypertension and diabetes treatment in southern Africa, and no data demonstrating mortality reduction. Where clinical visits for NCDs and HIV cannot be combined, integrated medication delivery presents an opportunity to streamline care and reduce patient costs. We present experiences of integrated HIV and NCD medication delivery in Eswatini and South Africa, focusing on programme successes and implementation challenges. Programmatic data from Eswatini's Community Health Commodities Distribution (CHCD) from April 2020 to December 2021 and South Africa's Central Chronic Medicines Dispensing and Distribution (CCMDD) from January 2016 to December 2021 were provided by programme managers and are summarized here.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Launched in 2020, Eswatini's CHCD provides over 28,000 people with and without HIV with integrated services, including HIV testing, CD4 cell count testing, antiretroviral therapy refills, viral load monitoring and pre\u2010exposure prophylaxis alongside NCD services, including blood pressure and glucose monitoring and hypertension and diabetes medication refills.\u00a0 Communities designate neighbourhood care points and central gathering places for person\u2010centred medication dispensing.\u00a0 This programme reported fewer missed medication refill appointments among clients in community settings compared to facility\u2010based settings. South Africa's\u00a0CCMDD utilizes decentralized drug distribution to provide medications for over 2.9 million people, including those living with HIV, hypertension and diabetes.\u00a0 CCMDD incorporates community\u2010based pickup points, facility \u201cfast lanes\u201d and adherence clubs with public sector health facilities and private sector medication collection units.\u00a0 There are no out\u2010of\u2010pocket payments for medications or testing commodities.\u00a0 Wait\u2010times for medication refills are lower at CCMDD sites than facility\u2010based sites.\u00a0 Innovations to reduce stigma include uniformly labelled medication packages for NCD and HIV medications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Eswatini and South Africa demonstrate person\u2010centred models for HIV and NCD integration through decentralized drug distribution. This approach adapts medication delivery to serve individual needs and decongest centralized health facilities while efficiently delivering NCD care.\u00a0 To bolster programme uptake, additional reporting of integrated decentralized drug distribution models should include HIV and NCD outcomes and mortality trends.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.26113","type":"journal-article","created":{"date-parts":[[2023,7,6]],"date-time":"2023-07-06T07:11:08Z","timestamp":1688627468000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Person\u2010centred, integrated non\u2010communicable disease and HIV decentralized drug distribution in Eswatini and South Africa: outcomes and challenges"],"prefix":"10.1002","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1858-3905","authenticated-orcid":false,"given":"Deborah","family":"Goldstein","sequence":"first","affiliation":[{"name":"Office of HIV\/AIDS USAID  Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan","family":"Ford","sequence":"additional","affiliation":[{"name":"Global HIV Hepatitis and Sexually Transmitted Infections Programmes World Health Organization  Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Kisyeri","sequence":"additional","affiliation":[{"name":"Eswatini National AIDS Program Mbabane Eswatini"},{"name":"ICAP Columbia University Mbabane Eswatini"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maggie","family":"Munsamy","sequence":"additional","affiliation":[{"name":"National Department of Health Pretoria South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lirica","family":"Nishimoto","sequence":"additional","affiliation":[{"name":"FHI 360  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kufor","family":"Osi","sequence":"additional","affiliation":[{"name":"Resolve to Save Lives  Abuja Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herve","family":"Kambale","sequence":"additional","affiliation":[{"name":"ICAP Columbia University Mailman School of Public Health  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Minior","sequence":"additional","affiliation":[{"name":"Office of HIV\/AIDS USAID  Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9442-7854","authenticated-orcid":false,"given":"Moses","family":"Bateganya","sequence":"additional","affiliation":[{"name":"FHI 360  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,7,6]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"UNAIDS.HIV and ageing. UNAIDS Programme Coordinating Board (39)\/16.26. Issue date: 22 November 2016. Thirty\u2010Ninth Meeting. 6\u20138 December 2016. Available from:https:\/\/www.unaids.org\/sites\/default\/files\/media_asset\/20161125_UNAIDS_PCB39_HIV\u2010Ageing_EN.pdf. access: October 1 2022."},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000001754"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciab995"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000001888"},{"key":"e_1_2_8_6_1","unstructured":"ChangD EsberA DearN IroezinduM BahemanaE KibuukaH et\u00a0al.Non\u2010communicable diseases in older persons living with and without HIV in four African countries [abstract]. Presented at International Workshop on HIV & Aging; 2021 Sep 23\u201324. Abstract 0\u20137. Available from:https:\/\/academicmedicaleducation.com\/meeting\/international\u2010workshop\u2010hiv\u2010aging\u20102021\/abstract\/o\u20107\u2010chang\u2010david\u2010non\u2010communicable\u2010diseases. 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Poster presented at AIDS","author":"Kisyeri N"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-021-06450-z"},{"key":"e_1_2_8_18_1","unstructured":"PininiZ.Providing HIV diabetes and hypertension treatment refills outside of health facilities in South Africa. Presented July 2021 virtually at IAS 2021."},{"key":"e_1_2_8_19_1","unstructured":"ManganyeM.Differentiated service delivery for people with HIV and non\u2010communicable diseases: South African policy enabler for integration. Presented July 2022 at AIDS;Montreal Canada."},{"key":"e_1_2_8_20_1","volume-title":"Does type of pickup\u2010point influence 12\u2010month virologic suppression in South Africa?","author":"Bassett IV"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-035412"}],"container-title":["Journal of the International AIDS Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jia2.26113","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,17]],"date-time":"2023-08-17T02:25:15Z","timestamp":1692239115000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jia2.26113"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7]]},"references-count":20,"journal-issue":{"issue":"S1","published-print":{"date-parts":[[2023,7]]}},"alternative-id":["10.1002\/jia2.26113"],"URL":"https:\/\/doi.org\/10.1002\/jia2.26113","archive":["Portico"],"relation":{},"ISSN":["1758-2652","1758-2652"],"issn-type":[{"value":"1758-2652","type":"print"},{"value":"1758-2652","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7]]},"assertion":[{"value":"2022-11-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-05-09","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-07-06","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e26113"}}