AMBIT Resources

For AIDS 2022 posters and slides, click here.

For SA AIDS 2023 posters and slides, click here.

Costs and economic evaluations of differentiated HIV treatment

Benade M, Nichols B, Fatti G, Kuchukhidze S, Takarinda K, Mabhena-Ngorima N, Grimwood A, Rosen S. Economic evaluation of a cluster randomized, non-inferiority trial of differentiated service delivery models of HIV treatment in Zimbabwe. (Research supported by USAID/PEPFAR under EQUIP.) PLOS Global Public Health 2023; 3: e0000493.

Guthrie T, Muheke C, Rosen S, Kanoowe S; Lagony S; Greener R; Miot J; Balidawa H; Kiggundu J; Calnan J; Dejene S; Xulu T; Sigwebele N; Long L. Similar costs and outcomes for differentiated service delivery models for HIV treatment in Uganda. BMC Health Services Research (2022) 22:1315. (Research supported by USAID/PEPFAR under EQUIP.)

Rosen S, Nichols B, Guthrie T, Benade M, Kuchukhidze S, Long L. Do differentiated service delivery models for HIV treatment in sub-Saharan Africa save money? Synthesis of evidence from field studies conducted in sub-Saharan Africa in 2017-2019. Gates Open Research 2021, 5:177

Nichols BE, Rosen S. Economic evaluations of differentiated service delivery should include savings and ancillary benefits, not only health system costs: authors’ reply. AIDS 2021;35:2235-2236.

Nichols BE, Cele R, Lekodeba N, Tukei B, Norima-Mabhena N, Tiam A, Maotoe T, Sejana MV, Faturiyele I, Chasela C, Rosen S, Fatti G. Economic evaluation of a cluster randomized trial of differentiated service delivery models for HIV treatment in Lesotho: costs to providers and patients. J Int AIDS Soc 2021; 24: e25692. (Research supported by USAID/PEPFAR under EQUIP.)

Nichols BE, Cele R, Jamieson L, Long L, Siwale Z, Banda P, Moyo C, Rosen S. Community-based service delivery of HIV treatment in Zambia: costs and outcomes. AIDS 2021:299-306. PMID: 33170578. (Research supported by USAID/PEPFAR under EQUIP.)

Larson BA, Pascoe S, Huber A, Long L, Murphy J, Miot J, Fox MP, Fraser-Hurt N, Rosen S. Will differentiated care for stable HIV patients reduce healthcare systems costs? J Int AIDS Soc 2020; 23:e25541. (Research supported by USAID/PEPFAR under INROADS.)

Do DSD models for HIV treatment save money for health systems? Primary data from Zambia, Uganda, Lesotho, Zimbabwe, and Malawi. AMBIT/CQUIN/EQUIP webinar, September 22, 2020.

Costs of DSD models for HIV treatment in Africa. January 2020; presented at BMGF HIV Costing Convening, Washington, DC, January 6, 2020.

Differentiated service delivery eligibility, uptake, and clinical outcomes

Maskew M, Rosen S. Estimating the impact of differentiated models for HIV care (commentary). Lancet HIV 2023; 10: e628-29.

Jo Y, Jamieson L, Phiri B, Grimsrud A, Mwansa M, Shakwelele H, Haimbe P, Mukumbwa-Mwenechanya M, Mulano Mulenga P, Nichols BE, Rosen S. Attrition from HIV treatment after enrollment in a differentiated service delivery model: a cohort analysis of routine care in Zambia. PLOS One 2023; 18: e0280748

Jamieson L, Rosen S, Phiri B, Grimsrud A, Mwansa M, Shakwelele H, Haimbe P, Mwenechanya MM, Lumano Mulenga P, Nichols BE. How soon should patients be eligible for differentiated service delivery models for antiretroviral treatment? Evidence from Zambia. BMJ Open 2022;

Jo Y, Rosen S, Sy KTL, Phiri B, Huber AN, Mwansa M, Shakwelele H, Haimbe P, Mwenechanya MM, Lumano Mulenga P, Nichols BE. Changes in HIV treatment differentiated care uptake during the COVID-19 pandemic in Zambia: interrupted time series analysis. J Int AIDS Soc 2021;24 (Suppl6): e25808.

Huber A, Pascoe S, Nichols B, Long L, Kuchukhidze S, Phiri B, Tchereni T, Rosen S. Differentiated service delivery models for HIV treatment in Malawi, South Africa, and Zambia: a landscape analysis. Glob Heal Sci Pract 2021;9(2).

Hoffman RM, Moyo C, Balakasi K, Siwale Z, Hubbard J, Bardon A, Fox MP, Kakwesa G, Kalua T, Haambokoma M, Dovel K, Campbell P, Tseng C, Pisa TP, Cele R, Gupta S, Benade M, Long L, Xulu T, Sanne I, Rosen S. Multi-month dispensing of up to six months of antiretroviral therapy in Malawi and Zambia: Results of a cluster-randomized trial. Lancet Global Health 2021; 9: E628-E638. (Research supported by USAID/PEPFAR under EQUIP.)

Hoffman RM, Balakasi K, Bardon A, Siwale Z, Hubbard J, Kakwesa G, Maambokoma M, Kalua T, Pisa P, Moyo C, Dovel K, Xulu T, Sanne I, Fox MP, Rosen S, for EQUIP Health. Eligibility for differentiated models of HIV treatment service delivery: an estimate from Malawi and Zambia. AIDS 2020; 34:475–479. (Research supported by USAID/PEPFAR under EQUIP.)

Do differentiated service delivery models work for second-line therapy? Outcomes for South African second-line ART clients enrolled in DSD models compared to conventional care. Presentation at ADHERENCE 2022.

The landscape of differentiated service delivery models in Malawi, South Africa, and Zambia. November, 2019; presented at CQUIN Annual Conference.

Inventory of DSD studies and data South Africa (February 2019)

Non-clinical outcomes of differentiated service delivery

No differences in recipients of care perceived quality of care between differentiated service delivery models and conventional care in South Africa: Results of the first round of AMBIT’s Sentinel-South Africa survey. Presented at CQUIN Learning Network Workshop, April 2022.

CCMDD in South Africa: Client satisfaction with CCMDD and conventional care (June 2023)

CCMDD in South Africa: Provider workload, responsibilities, and time use (June 2023)

SENTINEL 1 SA client satisfaction policy brief (July 2023)

Literature reviews

Long L, Kuchukhidze S, Pascoe S, Nichols BE, Fox MP, Cele R, Govathson C, Huber AN, Flynn D, Rosen S. Retention in care and viral suppression in differentiated service delivery models for HIV treatment in sub-Saharan Africa: a rapid systematic review. J Int AIDS Soc 2020; 23: e25640.

Long L, Kuchukhidze S, Pascoe S, Nichols B, Cele R, Govathson C, Huber A, Flynn D, Rosen S. Differentiated models of service delivery for antiretroviral treatment of HIV in sub-Saharan Africa: A rapid review protocol. Systematic Reviews 2019; 8:314.

Multi-month dispensing of antiretroviral medications (March 2020)

Frequency of healthcare system interactions in differentiated service delivery models for HIV treatment (March 2020)

Patient satisfaction with differentiated service delivery models of HIV treatment in sub-Saharan Africa (March 2020)

Patient and provider costs associated with DSD models for HIV treatment in sub-Saharan Africa. (November, 2019; presented at CQUIN Annual Conference)

Research agendas, commentaries, and study protocols and data collection instruments

Pascoe S, Huber A, Mokhele I, Lekodeba N, Ntjikelane V, Sande L, Tcherini T, Haimbe P, Rosen S, for the AMBIT SENTINEL study team. The SENTINEL study of differentiated service delivery models for HIV treatment in Malawi, South Africa, and Zambia: research protocol for a prospective cohort study. BMC Health Services Research 2023; 23:891.

Ehrenkranz P, Rosen S, Boulle A, Eaton J, Fox MP, Ford N, Grimsrud A, Rice BD, Sikazwe I, Holmes C. The revolving door of HIV care: Revising the care cascade to achieve the 95-95-95 goals. PLOS Med 2021; 18: e1003651.

Rosen S, Grimsrud A, Katz I, Ehrenkranz P. Models of service delivery for optimizing a patient’s first six months on ART: an applied research agenda. Gates Open Res 2020, 4:116.

Ford N, Geng E, Ellman T, Orrell C, Ehrenkranz P, Sikazwe I, Jahn A, Rabkin M, Addo S, Grimsrud A, Rosen S, et al. Emerging priorities for HIV service delivery. PLOS Med 2020; 17(2): e1003028.

Stakeholder questionnaire (April 2019)

GREAT protocol for routine data collection (example: Malawi) (May 2019)

SENTINEL protocol for primary data collection (example: Malawi) (February 2021) (includes data collection instruments)

SENTINEL Round 1 data collection status report (March 10, 2022)

Project descriptions

Project proposal (May 2018)

AMBIT poster (November 2018)

Project summary (February 2019)