Table 1 Core and periphery components, procedures, and visits of same-day antiretroviral therapy
SDART core components | Adapted periphery components | SDART procedures | Timepoint | |||
|---|---|---|---|---|---|---|
Initiation visit: day 0 | Follow-up visit: day 14 | Refer-out: day 45 | Long-term follow-up: day 46–day 730 | |||
Interactive counseling to assist clients to make an informed decision regarding ART initiation and lifelong adherence as well as to set positive treatment and self-care goals in order to achieve viral suppression | Increasing the role of KP lay provider in leading ART initiation service in addition to their case management and support role; adding option to return to CBO for point-of-care viral load testing at 6 months after ART initiation | CB-SDART eligibility assessment | ✓ | |||
Psychosocial readiness and willingness assessment | ✓ | |||||
Ongoing counseling and adherence support provided by peer navigators | ✓ | ✓ | ✓ | ✓ | ||
Screening to rule out serious opportunistic infections before ART initiation | Chest X-ray and selected laboratory testing conducted outside of the clinic; adding point-of-care CD4 count testing to aid ART initiation and physical examination led by KP lay providers under the remote supervision of physicians | Symptomatic screening | ✓ | |||
Sample collection for baseline laboratory testing, STI sample collection (if accepted) | ✓ | |||||
Chest X-ray | ✓ | |||||
Informing baseline laboratory test results | ✓ | |||||
ART initiation within the same day of HIV diagnosis for clients who are ready and willing to start ART without clinical complications, if possible | Adding ART initiation and follow-up options, including in-person at the CBOs or via telehealth, with KP lay providers or physicians; adding ART home delivery option | ART prescription | ✓ | |||
Management of adverse drug events | ✓ | |||||
ART modification (if required) and refill | ✓ | |||||
Referral system at the ready to assist clients to change their facility coverage according to their national health insurance and in referral process | KP lay providers assisting clients in navigating the health system and in the referral process | Refer for OI investigation (for clinically ineligible clients) | ✓ | |||
Change in facility coverage to utilize the national health insurance (if requested) | ✓ | |||||
Warm-hand off (if requested) | ✓ | |||||