Grimsrud A, Anam FR, Johnson CC, Katz IT, Sikazwe I, Sundaram M, Wilkinson LS. Differentiated service delivery and self-care in HIV. Lancet HIV. 2026 Jul 1:S2352-3018(26)00149-9. doi: 10.1016/S2352-3018(26)00149-9. Epub ahead of print. PMID: 42385759.
Since 2025, shifts in the global HIV landscape, including changing international financing, expanding integration, increasing emphasis on country ownership, and rapid growth in digital health technologies, require a fundamental reconsideration of how HIV services should be delivered and sustained. Health systems are increasingly being forced to determine what must be protected, what can be simplified, and where responsibility for care should lie. In this context, differentiated service delivery (DSD) and self-care are frequently discussed in parallel, yet their relationship remains insufficiently defined within HIV policy and implementation. This conceptual ambiguity risks policy confusion, recentralisation, over-medicalisation, and missed opportunities to leverage the complementary strengths of both approaches.
