Table 1.

Strategy facility selection criteria.

Strategies	Description	Selection criteria
1. Status quo	All viral load specimens are sent for centralized testing.	All facilities in South Africa that currently send viral load specimens to centralized laboratories
2. Unsuppressed targeted	Targeted POC for patients suspected of viral failure at facilities with low suppression rates/high numbers of unsuppressed viral loads	Facilities with at least one unsuppressed viral load expected daily or facilities with the lowest viral suppression rates (less than 80% – quintile 4 and 5) but at least 4 viral loads expected per day were selected for this strategy. Only primary healthcare facilities and district level hospitals were included.
3. Combination targeted	POC coverage at facilities with a combination of low suppression rates, and high rejection rates and TAT	Facilities were divided into quintiles according to their viral load specimen rejection rates, viral load suppression rates, and TAT. Facilities were scored based on their total quintile score, and sorted in descending order. The lowest performing facilities according to these indicators (low viral suppression, long TAT and high specimen rejection rates) were selected for POC coverage until 15% of national viral load volumes were covered* Only primary healthcare facilities and district level hospitals were included.
4. All POC	A complete switch from centralized to POC testing	All facilities in South Africa that currently send viral load specimens to centralized laboratories were allocated POC instruments according to their viral load volumes.

^⁎15% coverage is typically required to ensure the lowest cost per test in pricing agreements with volume commitments.