HIV Clubs, South Africa
Starting in 2011, Adherence clubs (ACs) for people established on treatment were rolled-out in the Cape Town Metro health district of South Africa. ACs, now known as HIV Clubs, are groups of 25-30 clients established on treatment who meet for 30-60 minutes. The Club is facilitated by a lay provider who provides a brief symptom screen, referral where necessary, peer support and distribution of pre-packed ART to all the members present every 2-3 months (4-6 times a year). No client folders are pulled; nor is individual adherence counselling provided. Group members have their viral load taken at one of their annual group visits and are seen individually for clinical review at their next group visit.
They also have access to clinicians through the model referral mechanisms if they become unwell. Group members are allowed to send a friend or family member to collect their ART drug supply in the group. Group attendance is recorded as a client visit in the paper-based registers, which are then captured in the facility’s electronic monitoring system (EMR). Clubs are an example of a health care worker-managed group model.
Eligibility
Same ART regimen for 6 months, 1st or 2nd line ART, recent undetectable VL, no active TB, no condition requiring regular clinical follow up, adult (>18 years).
Building Blocks
ART refills
What
Pre-packed ART
Brief symptom screen
When
2-4 monthly
Where
Primary care clinics providing ART
Community venues
Who
Lay provider
Clinical consultations
What
Pre-packed ART
Comprehensive clinical consultation
When
Annual
Where
Primary care clinic
Who
Nurse
Psychosocial support
What
Group (25-30 members) counselling session
When
2-4 monthly
Where
Primary care clinics providing ART
Community venues
Who
Lay provider
Variations for specific populations and contexts
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Teen clubs, Malawi
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Family member ART refill, Zimbabwe
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Postnatal clubs, South Africa
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Medication adherence clubs with non-communicable disease (NCD) integration, Kenya
In Kibera, Kenya, there was a high volume of people living with HIV, as well as clients with hypertension and diabetes. Building on the experience of group models for clients…
HIV clubs with integrated tuberculosis preventive therapy (TPT), South Africa
Adherence clubs (ACs) for people established on treatment were rolled-out in the Cape Town Metro health district of South Africa in 2011. ACs, now known as HIV Clubs, are groups…
