Table 2 Study interventions, type of intervention, and target step in the HIV care continuum
Intervention | Standard of care (SOC) | Combination intervention strategy (CIS) | Type of intervention | Step targeted in HIV care continuum |
|---|---|---|---|---|
Point-of-care CD4+ count testing | • Point-of-care CD4 assays available in some primary care clinics and some secondary health centers/hospitals for patients enrolled in HIV care but only used once a patient has linked to care | • Point-of-care CD4 assays at the HIV testing site at the time of HIV testing | Structural and biomedical | Linkage and ART initiation |
• Turnaround time immediate |  |  | ||
|  | • All clinics have CD4 (Cyflow, FACS Caliber) availability after linkage to HIV care in the clinic or lab |  |  |  |
|  | • Turnaround time approximately 2 weeks |  |  |  |
Accelerated ART initiation | • ART initiation per national guidelines for patients with CD4 ≤350 cells/μL or WHO stage III/VI | • Accelerated ART initiation for patients with point-of-care CD4 ≤350 cells/μL within 1 week from testing | Structural and biomedical | ART initiation and retention |
|  | • Requires 3 counseling sessions and receipt of baseline lab tests | • 2 counseling sessions (one at the time of HIV testing and another at the first HIV clinic visit), and collection of blood for other baseline lab tests, but ART initiation prior to return of results for patients who do not meet the criteria for waiting for receipt of lab results prior to ART initiation |  |  |
• Initiation 2 weeks–1 month from testing | ||||
Cellular appointment reminders | • Telephone call within 7 days of missed appointment for ART patients only | • Short message service (SMS) (or voice if illiterate) appointment reminders 1 day prior to each scheduled appointment | Behavioral | Linkage and retention |
|  |  | • SMS (or voice if illiterate) reminder within 7 days after a missed appointment |  |  |
Care and prevention services | • Cotrimoxazole prescribed for all patients once enrolled in HIV care | • Basic care and prevention package provided approximately every 3 months. Package includes condoms, soap, cotrimoxazole, pillbox, and pictorial education about the use of materials and HIV, such as family testing tools and information | Biomedical and behavioral | Retention |
• Condoms available | ||||
Non-cash financial incentive | • None | • Non-cash financial incentive (mobile airtime) provided for linkage within 1 month of testing and retention at 6 and 12 months | Structural | Linkage and retention |