Comparison of Providers' and Clients' Perceived Challenges and Benefits of 6-Month ART Dispensing Interval, 10 Health Facilities in Malawi

Socioecological Model ThemeClientProvider
Sharing ARTOnly 1 client reported sharing; all others did not shareConsidered a common problem, particularly sharing among partners
Storage of ARTNo reported challengesPerception that clients have challenges storing increased ART supply
Unwanted HIV status disclosure to communityReported minimal challenges with easy adaptation strategies to avoid unwanted disclosureDid not report challenges with pill carrying but perceived adaptive behaviors (i.e., using different bags)
Selling ARTNo reports of personal experience with sellingNo concern about selling
Visits for ART refillsReduced number of visits
Reduced cost
Increased time and ability to attend to family and work demands
Reduced clients' costs and time
Reduced providers' workload and clinic congestion
Improved ability to see newly initiated/unwell clients
Visits for acute health needsReported returning for acute illnesses frequentlyPerceived delays in clients' health-seeking behaviors