The establishment of viremia clinics was an initiative to address the gaps and challenges in the monitoring and management of patients with high VL, and function as a form of differentiated care for unstable clients with high VL. Held at least one day a month, the viremia clinic utilizes a multidisciplinary team (MDT) model and focuses on enhanced case management and a patient-centered approach. This model is aimed at identifying patient-specific adherence barriers and tailoring interventions to address the patients’ specific needs. Patients are empowered to make joint decisions with their providers to improve their ART adherence.
The Western Cape Government Department of Health adopted the adherence club (AC) model for the Cape Metro district in January 2011. The ART-AC model provides patient-friendly access to ART for clinically stable patients, ART distribution, and care and support to groups of stable patients. ACs can reduce the burden that stable patients place on healthcare facilities, freeing healthcare workers to treat new and unstable patients.