The evidence base for differentiated care for stable patients has grown in recent years. There has been less attention, however, to developing differentiated models of care for patients with advanced or unstable HIV disease. Current clinical guidelines and policies regarding optimal packages of care for high-risk patients give few or no recommendations about how, by whom, or where they should be delivered for optimal impact.
Although WHO and a number of national HIV treatment guidelines recommend specific interventions and services to provide to patients with advanced or unstable HIV, differentiated models of care addressing the “how” rather than the “what” have not been tested, and these elements are rarely specified in guidelines.
Development of differentiated models for unstable patients and those with advanced HIV disease will be a priority as differentiated service delivery expands and matures. The CQUIN network developed this call-to-action to define the target populations of interest, describe the currently recommended packages of care, and review available differentiated care models. It will serve as a call to action to motivate stakeholders to share their experiences, generate new evidence, and to advocate for attention to this high-risk population.