Experiences of Patients and Healthcare Providers on Differentiated Antiretroviral Therapy Service Delivery Models in Ethiopia: A Mixed Methods Study
1
Pharmacology and Clinical Pharmacy, Addis Ababa University, Addis Ababa, Ethiopia
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
Following the WHO's 2016 recommendation, Ethiopia adopted differentiated antiretroviral therapy DSD models for HIV care to improve health outcomes. Despite widespread adoption, there is limited evidence on the experiences of patients and healthcare providers regarding these models in Ethiopian settings.
OBJECTIVE:
To investigate experiences of patients and healthcare providers on DSD models in Ethiopia.
METHODS:
A mixed-methods sequential explanatory study design was undertaken in 10 health facilities. A consecutive sampling of 422 PLWH were enrolled, while 13 healthcare professionals and 11 PLWH were purposively selected for an in-depth interview. Patient satisfaction was assessed using the Treatment Satisfaction with Medicines questionnaire. We performed multivariable Tobit regression to identify factors associated with overall patient satisfaction.
RESULTS:
A total of 415 PLWH were included in the final data analysis. About two-thirds (266, 64.1%) of the participants were female, and the majority (185, 44.6%) of PLWH were enrolled in the Appointment Spacing Model. The median score for patient satisfaction was 76.5 [67.7-80.9], and no satisfaction difference was observed among the DSD models (p-value > 0.5). The findings indicated that suppressed viral load (β = 4.83, CI: 0.05-9.62) and high adherence level (β = 6.02, CI: 0.84-11.19) were significantly positively associated with overall satisfaction. In contrast, being on a regimen other than the first-line treatment was negatively associated with overall satisfaction (p-value < 0.05). The themes that emerged from the qualitative datasets were service efficiency, perceived patient outcomes, and integration of HIV care with other chronic diseases.
CONCLUSIONS:
The study showed that PLWH expressed high levels of satisfaction with DSD models. High adherence level, being on other than first-line regimen, and suppressed viral load were significantly associated with overall satisfaction. To improve the effectiveness of DSD models, efforts should address barriers including stigma, low awareness, and supply chain inconsistencies.
Following the WHO's 2016 recommendation, Ethiopia adopted differentiated antiretroviral therapy DSD models for HIV care to improve health outcomes. Despite widespread adoption, there is limited evidence on the experiences of patients and healthcare providers regarding these models in Ethiopian settings.
OBJECTIVE:
To investigate experiences of patients and healthcare providers on DSD models in Ethiopia.
METHODS:
A mixed-methods sequential explanatory study design was undertaken in 10 health facilities. A consecutive sampling of 422 PLWH were enrolled, while 13 healthcare professionals and 11 PLWH were purposively selected for an in-depth interview. Patient satisfaction was assessed using the Treatment Satisfaction with Medicines questionnaire. We performed multivariable Tobit regression to identify factors associated with overall patient satisfaction.
RESULTS:
A total of 415 PLWH were included in the final data analysis. About two-thirds (266, 64.1%) of the participants were female, and the majority (185, 44.6%) of PLWH were enrolled in the Appointment Spacing Model. The median score for patient satisfaction was 76.5 [67.7-80.9], and no satisfaction difference was observed among the DSD models (p-value > 0.5). The findings indicated that suppressed viral load (β = 4.83, CI: 0.05-9.62) and high adherence level (β = 6.02, CI: 0.84-11.19) were significantly positively associated with overall satisfaction. In contrast, being on a regimen other than the first-line treatment was negatively associated with overall satisfaction (p-value < 0.05). The themes that emerged from the qualitative datasets were service efficiency, perceived patient outcomes, and integration of HIV care with other chronic diseases.
CONCLUSIONS:
The study showed that PLWH expressed high levels of satisfaction with DSD models. High adherence level, being on other than first-line regimen, and suppressed viral load were significantly associated with overall satisfaction. To improve the effectiveness of DSD models, efforts should address barriers including stigma, low awareness, and supply chain inconsistencies.
| eISSN: | 2654-1459 |
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