{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:01:56Z","timestamp":1792108916804,"version":"4.4.0"},"reference-count":32,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Wollo University"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Int Assoc Provid AIDS Care"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Differentiated service delivery models (DSDMs) are client-centered approaches to HIV care that improve efficiency through simplification, task shifting, and decentralization. However, utilization of Ethiopia's community-based DSDM remains low, and its determinants are not well understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess the utilization of and factors associated with community-based DSDM among ART users in Dessie public health facilities, Northeast Ethiopia, 2025.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A convergent mixed-methods cross-sectional study was conducted among 635 randomly selected ART users. Quantitative data were collected using interviewer-administered questionnaires and analyzed using multivariable logistic regression in STATA 16. In-depth interviews with purposively selected ART users were analyzed thematically to explore contextual barriers and facilitators.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall, 17.1% (95% CI: 14.3-20.3%) utilized community-based DSDM. Utilization was positively associated with primary education, HIV status disclosure, and ART regimen change, but negatively associated with prior loss to follow-up and baseline CD4\u2009\u2265\u2009500 cells\/mm\n                      <jats:sup>3<\/jats:sup>\n                      . Qualitative findings highlighted information gaps, stigma, and misconceptions as barriers, while peer support facilitated uptake.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Community-based DSDM utilization remains suboptimal, underscoring the need for strengthened counseling, stigma reduction, and targeted patient education to enhance uptake.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23259582261423607","type":"journal-article","created":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T17:40:19Z","timestamp":1770831619000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Utilization and Associated Factors of the Community-Based Differentiated Service Delivery Model Among ART Users in Dessie Public Health Facilities, Northeast Ethiopia: A Mixed Method Study"],"prefix":"10.1177","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-2350-6438","authenticated-orcid":false,"given":"Endalkachew Mesfin","family":"Gebeyehu","sequence":"first","affiliation":[{"name":"School of Public Health, College of Medicine and Health Sciences, Wollo University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-8805-0046","authenticated-orcid":false,"given":"Eyob Tilahun","family":"Abeje","sequence":"additional","affiliation":[{"name":"School of Public Health, College of Medicine and Health Sciences, Wollo University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-0455-9460","authenticated-orcid":false,"given":"Lakew","family":"Asmare","sequence":"additional","affiliation":[{"name":"Institute of Public Health, College of Medicine and Health Sciences, University of Gondar"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,2,11]]},"reference":[{"key":"e_1_3_4_2_2","volume-title":"UNAIDS Fact Sheet","author":"Joint United Nations Programme on HIV\/AIDS","year":"2024","unstructured":"Joint United Nations Programme on HIV\/AIDS. 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