Differentiated antiretroviral therapy delivery and retention in care in rural Kenya: a cluster-randomised trial

Abstract

Differentiated service delivery models have been proposed to ease the burden on health systems while maintaining quality of care for people living with HIV. In this cluster-randomised trial across 24 facilities in western Kenya, we evaluated whether community-based ART delivery improved 12-month retention compared with standard facility-based care. Community-based delivery significantly improved retention and viral suppression while reducing patient-reported costs, supporting wider adoption of differentiated models in resource-limited settings.