Longitudinal Analysis to Assess the Contribution of the Multi-Month Scripting (MMS) Regime on ART Outcomes among Adult (15+) Persons Living with HIV in Zimbabwe

Acquired Immuno Deficiency Syndrome (AIDS) continue to be a major global public health concern. There are an estimated 1.3 million people living with in Zimbabwe and 1,100,000 million were estimated to be on Antiretroviral Therapy (ART) by 2018 [1]. As part of the continued efforts to scale up client focused ART program at a global level, WHO released guidance (the 2013 guidelines, followed by the 2016 guidelines) [2,3] focused on Differentiated Models of Care (DMC). DMC is meant to ensure that HIV services across the cascade reflect the preferences and expectations of various groups of people living with HIV, while enhancing service delivery. In Zimbabwe, two models of differentiated care for stable patients stand out: the adjusted appointment spacing through Multi-Month Scripting (MMS) and community ART groups (CAGs). MoHCC released an updated Operational and Service Delivery Manual for the Prevention, Care and Treatment of HIV in Zimbabwe (OSDM) in February 2017. This is the second edition of the manual originally developed in 2015. It sets out ‘how' to implement WHO's 2016 [3] clinical guidelines, including differentiated service delivery (DMC) across the entire HIV cascade from prevention to suppression. The aim of the study is to assess the contribution of the Multi-Month Scripting (MMS) regime on ART outcomes among adult persons living with HIV in Zimbabwe.