Table 1.
Roles of primary care clinics with and without ART assessment sites in the delivery of elements of HIV care before and during the STRETCH intervention
| Primary care clinics without accredited ART site | Primary care clinics with accredited ART assessment site functioning within the clinic | |
|---|---|---|
|
Organisation of HIV care before the STRETCH trial | ||
|
Delivery of pre-ART care (voluntary counselling and testing, initial CD4, 6–12 monthly HIV care) and ART care (baseline bloods, drug readiness training and monthly issuing of ARVs) |
• Primary care nurses identify and refer HIV positive patients to ART nurses at their referral primary care clinic with an accredited ART assessment site |
• Primary care nurses identify and refer HIV positive patients to ART nurses working within that clinic |
| • ART nurses provide pre-ART and ART care for all patients referred from primary care services | ||
| • All patients needing ART initiation and re-prescription referred by ART nurses to doctors at ART treatment sites | ||
|
Organisation of HIV care during the STRETCH trial (intervention clinics and their referring primary care clinics only) | ||
|
Delivery of pre-ART care (voluntary counselling and testing, initial CD4, 6–12 monthly HIV care) |
“Mainstreaming pre-ART care” |
“Internal integration of pre-ART care’ |
| • Primary care clinic enabled to provide pre-ART care to their own patients |
• All professional nurses (ART and primary care nurses) at intervention clinic encouraged to provide pre-ART care as part of routine consultations |
|
|
Delivery of ART care (baseline bloods, drug readiness training and monthly issuing of ARVs) |
“Mainstreaming ART care” |
“Internal integration of ART care” |
| • Primary care clinic enabled to provide ART care to their own patients |
• All professional nurses (ART and primary care nurses) at intervention clinic encouraged to provide ART care as part of routine consultations |
|
| Initiation and re-prescription of ART during STRETCH intervention | • All patients needing an ART prescription referred to ART nurses at intervention clinic | • All professional nurses (ART and primary care nurses) at intervention ART sites trained and authorised to initiate and repeat ART prescriptions |
| • Complicated patients referred to doctor at ART treatment site | ||