{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T21:44:52Z","timestamp":1781732692596,"version":"3.54.5"},"reference-count":18,"publisher":"Wiley","issue":"S3","license":[{"start":{"date-parts":[[2025,7,7]],"date-time":"2025-07-07T00:00:00Z","timestamp":1751846400000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["INV\u2010037138"],"award-info":[{"award-number":["INV\u2010037138"]}],"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":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Global and national guidelines recommend the integration of care for HIV and other chronic conditions to improve individual and public health outcomes. South Africa's differentiated service delivery (DSD) models extend beyond HIV care, relying on pickup points that also distribute hypertension (HTN) medications. We assessed the alignment between antiretroviral treatment (ART) and HTN medication collection visits and dispensing intervals as an indicator of integration progress.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The AMBIT project conducted a SENTINEL survey across 18 public clinics in three South African districts between September 2022 and April 2023, enrolling adult clients \u2265\u00a06 months on ART. We recruited up to 180 clients across each model of care: conventional care\u2010not DSD eligible (conventional\u2010not\u2010eligible); conventional care\u2010DSD eligible but not enrolled (conventional\u2010eligible); facility\u2010 (FAC\u2010PuP) and external (EX\u2010PuP) pickup points. Healthcare interaction data were extracted from paper and electronic sources for clients with a 12\u2010month observation period. We analysed both self\u2010reported alignment and actual visit data. We estimated the number and proportion of HTN visits aligned with ART dispensing. Log\u2010binomial regression estimated adjusted risk ratios (ARR) to assess the association with a higher visit burden (&gt;\u00a05 interactions).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 724 enrolled, 644 (90%) client records were successfully linked (76% female; median age 42; 15% Conventional\u2010not\u2010eligible; 17% Conventional\u2010eligible; 18% FAC\u2010PuP; 28% EX\u2010PuP). Among these, 85 (13%) with HTN (81 self\u2010reported, 4 from medical records), self\u2010reported 94% and 95% aligned facility visits and medication pickups, respectively. Visit data was retrieved for self\u2010reported HTN diagnoses. Of 477 visits for HIV\/HTN comorbid clients, 83% (395) dispensed both ART and HTN medication, and 97% had aligned dispensing durations (Conventional\u2010not\u2010eligible 97%, Conventional\u2010eligible 95%, FAC\u2010PuP 98%, EX\u2010PuP 100%). Comorbid clients had a similar visit burden to ART\u2010only clients (ARR 1.05, 95% CI: 0.80\u22121.39). FAC\u2010PuP (ARR 0.55, 95% CI: 0.40\u22120.78) and EX\u2010PuP (ARR 0.75, 95% CI: 0.57\u22120.98) clients were less likely than Conventional\u2010E clients to have high annual visit burden.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Aligning medication visits and dispensing for HIV and other chronic diseases marks an initial step towards integrated service delivery. Our results demonstrate achievable medication visit alignment without increased visit burden for comorbid clients and those in DSD models, suggesting that HIV\u2010HTN integration is feasible within DSD models, matching client preferences for comprehensive care.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.26444","type":"journal-article","created":{"date-parts":[[2025,7,7]],"date-time":"2025-07-07T10:30:21Z","timestamp":1751884221000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Aligning HIV treatment and hypertension clinic visits and dispensing as a first step towards service delivery integration in South Africa"],"prefix":"10.1002","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1010-3148","authenticated-orcid":false,"given":"Oratile","family":"Mokgethi","sequence":"first","affiliation":[{"name":"Health Economics and Epidemiology Research Office Faculty of Health Sciences University of the Witwatersrand  Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Huber","sequence":"additional","affiliation":[{"name":"Health Economics and Epidemiology Research Office Faculty of Health Sciences University of the Witwatersrand  Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Idah","family":"Mokhele","sequence":"additional","affiliation":[{"name":"Health Economics and Epidemiology Research Office Faculty of Health Sciences University of the Witwatersrand  Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khumbo","family":"Shumba","sequence":"additional","affiliation":[{"name":"Health Economics and Epidemiology Research Office Faculty of Health Sciences University of the Witwatersrand  Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinolia","family":"Ntjikelane","sequence":"additional","affiliation":[{"name":"Health Economics and Epidemiology Research Office Faculty of Health Sciences University of the Witwatersrand  Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6560-2964","authenticated-orcid":false,"given":"Sydney","family":"Rosen","sequence":"additional","affiliation":[{"name":"Health Economics and Epidemiology Research Office Faculty of Health Sciences University of the Witwatersrand  Johannesburg South Africa"},{"name":"Department of Global Health Boston University School of Public Health  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9199-8333","authenticated-orcid":false,"given":"Sophie","family":"Pascoe","sequence":"additional","affiliation":[{"name":"Health Economics and Epidemiology Research Office Faculty of Health Sciences University of the Witwatersrand  Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,7]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.7448\/IAS.19.1.21484"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-021-06561-7"},{"key":"e_1_2_11_4_1","unstructured":"MatjiR.Non\u2010communicable diseases in South Africa: findings from death notifications Statistician\u2010General [Internet] [cited 2024 May 7].2018. 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