Table 2.

Characteristics of studies included in the principal systematic literature review

Study ID	Location	Study design	Inclusion criteria	Sample size	CD4 at baseline (cells/mm3)	Frequency	Approach	Outcomes	Conclusions
Babigumira et al. [19]	Kampala, Uganda	Retrospective cohort	Treatment experienced HIV patients with CD4 > 200 cells/µL and adherence >95% and no age restriction	829	Mean:268 (SD: 154)	Monthly clinic visits (SOC) vs. clinic visits every six months (PRP)	PRP: task‐shifting from primary care provider to pharmacists	Adherence Morbidity Patient acceptability Costs	The PRP is more cost‐effective program than the standard of care
Blair et al. [13]	USA	RCT	Treatment experienced HIV patients with CD4 > 200 cells/µL and adherent with no age restriction	110	NR	Clinic visits every three months vs. every six months	Reduced visit frequency within centralized HIV care	Mortality Morbidity Viral failure	Trend towards less break­through viremia and an increase in CD4 counts in patients seen more frequently in clinic
Buscher et al. [14]	USA	Retrospective cohort	HIV patients with viral load < 400 copies/mL and no age restriction	2171	Median:497 (IQR: 345–692)	Clinic visits every three or four months vs. every six months	Reduced visit frequency within centralized HIV care	Retention Viral failure	Clinicians are able to make safe decisions extending follow‐up intervals in persons with viral suppression
Grimsrud et al. [23]	Western Cape, South Africa	Programme data	Stable HIV patients on ART and ≥eighteen years of age	1860	NR	Drug refill every two months (SOC) vs. every four months	Reduced drug refill within the community adherence club programme	Retention Viral failure	These findings suggest that less frequent visits for stable ART patients should be evaluated as regular practice to alleviate unnecessary burden on patients and clinic resources
*Grimsrud et al. [22]	Western Cape, South Africa	Programme data	Stable HIV patients on ART and ≥eighteen years of age	8150	Median:130 (IQR: 64–197)	Clinic visits every two months vs. every twelve months	Community based adherence clubs (CACs)	LTFU Viral rebound	Stable primary‐care patients were successfully managed by CACs. Higher rates of retention and viral suppression were maintained in both men and women
Jaffar et al. [25]	Jinja, Uganda	Cluster‐randomized equivalence trial	Patients with WHO stage IV or late stage III disease or CD4‐cell counts fewer than 200 cells/µL on ART and ≥eighteen years of age	1453	Median:110 (IQR: 40–175)	Home‐based care vs. facility‐based care	Home‐based ART delivery by community health worker	Mortality Adherence Retention Viral failure	Home‐based HIV‐care strategy is as effective as clinic‐based strategy
Kipp et al. [26,27]	Karabole, Uganda	Prospective cohort	Treatment‐naïve patients with CD4 > 200 cells/µL and ≥eighteen years of age	385	Hospital: 136.1 (range: 3–477) Community: 146.4 (range: 1–578)	Monthly in facility‐based care (SOC) vs. every six months with community‐based care	Community‐based ART delivery (CBART)	Mortality Viral rebound	Acceptable rates of virologic suppression were achieved using existing rural clinic and community resources
Luque‐Fernandez et al. [28]	Cape Town, South Africa	Comparative Cohort	Treatment experienced HIV patients with CD4 > 200 cells/µL and ≥eighteen years of age	2829	Median:202 (IQR: 97–386)	Monthly clinic visits vs. every six months	CACs	Mortality Retention Viral rebound Costs	Patient adherence groups were found to be an effective model for improving retention and documented virologic suppression for stable patients in long term ART care
McGuire et al. [17,20]	Rural Malawi	Comparative Cohort	Treatment experienced HIV patients with CD4 > 300 cells/µL and >95% Adherence and ≥fifteen years of age	3818	Median:534 (IQR: 420–692)	Clinic visits every 1–two months vs. every six months drug pick‐up every three months	Clinical six month appointments and every three months drug refill (called the SMA programme)	Mortality Retention	Nearly 97% of patients remained in HIV care after twelve months of SMA program inclusion and those in care achieved satisfactory treatment outcomes
Muñoz‐Moreno et al. [29]	Spain	Comparative Cohort	Treatment naïve or experienced HIV patients and no age restriction	180	NR	Drug refill every three months vs. every six months	Reduced drug refill	Adherence	Less frequency in collecting medication does not have a negative impact on adherence and permits to maintain high levels of compliance
Selke et al. [31,32]	Western Kenya	RCT	Treatment experienced HIV patients living in the Kosirai with high adherence and ≥eighteen years of age	208	Intervention: 305 (IQR: 227–430) SOC: 278 (IQR:186–397)	SOC – monthly clinic visits Intervention – clinic visits every three months	Community care coordinator (CCC): Patients trained by HIV‐infected peers in three month intervals	Mortality Adherence Retention Morbidity Viral failure Patient provider acceptability	Community‐based care resulted in similar clinical outcomes as usual care but with half the number of clinic visits

RCT: randomized controlled trial; SOC: standard of care; PRP: pharmacy refill programme; PRP: Pharmacy‐only refill program; CBART: community‐based ART; FBART: facility‐based ART; IQR: Interquartile range. *This study was not included in the analyses due to non‐compatible data but did provide qualitative data to the review.