Effect of Differentiated Service Delivery Model on Retention to Care among People Living with HIV in Rwanda: A Retrospective Cohort Analysis

• DOI: 10.4314/rjmhs.v8i1.1
• Publication Date: 2025-05-05T11:47:13Z
• Authors: Jackson Sebeza; Habib Ramadhan; David J Riedel; Peter Memiah; Marie-Claude Lavoie; Deyessa Negussie; Simeon Tuyishime; Gallican Rwibasir...; Charles Muiruri; Kristen Stafford

IntroductionThe differentiated service delivery (DSD) model, characterized by early antiretroviral therapy (ART) initiation, is supported peer educators to enhance treatment adherence improve retention in care among People Living with HIV (PLHIV). The study assessed effect of the DSD model on PLHIV Kigali City, Rwanda.MethodsA retrospective cohort design was used evaluate comparing pre- and post-DSD cohorts 976 ART-naïve aged ≥ 17 years who initiated ART between 2014 2019. To assess retention, we multivariable logistic regression models estimate adjusted odds ratio (aOR) corresponding 95% confidence intervals (CI). Covariates, namely demographics, body weight, immunological status, adherence, were included model.ResultsOf participants evaluated, 903 (92.5%) retained care. While did not significantly affect [aOR = 1.11, (95% CI: 0.67 – 1.85), p 0.675)], 90% strongly associated higher 2.20, 1.31–3.68), 0.003).ConclusionThese findings align latest literature, showing comparable patterns before after introducing DSD. Rwanda J Med Health Sci 2025;8(1):6-16