Overview

These guidelines provide new and updated recommendations and good practice statements in the following areas: starting ART, including initiating treatment outside the clinic and support for same-day ART start; frequency of clinical visits and ART refills; measuring adherence; tracing and re-engagement in care for all populations; psychosocial support for adolescents living with HIV; task sharing for diagnostic services; and service integration.

This guideline seeks to provide support to Member States, programme managers, health workers and other stakeholders seeking to achieve national and international goals to end the HIV epidemic as a public health threat by 2030.

WHO is currently in the process of collating all HIV normative guidance developed since 2016 in order to publish the third edition of the consolidated HIV guidelines in July 2021. This updated version will include the new service delivery guidance presented here.

Contents

• I. ACKNOWLEDGEMENTS
• II. ABBREVIATIONS AND ACRONYMS
• III. DEFINITION OF KEY TERMS
• IV. EXECUTIVE SUMMARY
• 1. BACKGROUND
  • 1.1. Objectives
  • 1.2. Target audience
  • 1.3. Guiding principles
  • 1.4. Methods for developing these guidelines
  • 1.5. Differentiated service delivery for HIV treatment
• 2. PEOPLE-CENTRED CARE
  • Background and rationale
• 3. INITIATING ART OUTSIDE THE HEALTH FACILITY
  • Background and rationale
  • Benefits and harms
  • Feasibility, cost and cost effectiveness
  • Equity and acceptability
  • Implementation considerations
  • Research gaps
• 4. RAPID INITIATION OF ART, INCLUDING SAME-DAY START
  • Background and rationale
• 5. FREQUENCY OF CLINICAL VISITS AND ART PICK-UP
  • Background and rationale
  • Benefits and harms
  • Feasibility, cost and cost effectiveness
  • Equity and acceptability
  • Implementation considerations
  • Research gaps
• 6. TRACING AND RE-ENGAGEMENT IN CARE
  • Background and rationale
  • Benefits and harms
  • Feasibility, cost and cost effectiveness
  • Equity and acceptability
  • Implementation considerations
  • Research gaps
• 7. ASSESSING ADHERENCE
  • Background and rationale
• 8. INTEGRATING SERVICES
  • 8.1. Integrating sexual and reproductive health services, including contraception, within HIV services
  • 8.2. Integrating diabetes and hypertension care with HIV care
• 9. PSYCHOSOCIAL INTERVENTIONS FOR ADOLESCENTS AND YOUNG ADULTS LIVING WITH HIV
  • Background and rationale
  • Benefits and harms
  • Feasibility, cost and cost effectiveness
  • Equity and acceptability
  • Implementation considerations
  • Research gaps
• 10. TASK SHARING OF SPECIMEN COLLECTION AND POINT-OF-CARE TESTING
  • Background and rationale
  • Benefits and harms
  • Feasibility, cost and cost effectiveness
  • Equity and acceptability
  • Implementation considerations
  • Research gaps
• 11. DIAGNOSTIC INTEGRATION
  • Background and rationale
• 12. DISSEMINATING, ADAPTING AND IMPLEMENTING THE GUIDELINES
  • Media and formats
  • Implementation
  • Updating
• References
• Annex. Process of developing the guidelines

Suggested citation:

Updated recommendations on service delivery for the treatment and care of people living with HIV. Geneva: World Health Organization; 2021. Licence: CC BY-NC-SA 3.0 IGO.

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