BACKGROUND: Despite widespread recognition that person-centered care (PCC) underpins high-quality HIV services, identifying approaches to operationalize PCC remains a challenge. JSI conducted a desk review and co-creation workshops with 39 colleagues from diverse geographies and health areas to develop a PCC framework grounded in behavioral science. This framework has proven to support implementers and service providers design and implement person-centered strategies that improve HIV services and outcomes.

The PCC framework features five principles realized through six domains. Interventions can be designed and implemented through each domain at any level of the socio-ecological model.

The USAID The USAID DISCOVER-Health and USAID Strengthening the Care Continuum projects implemented interventions across domains and socio-ecological levels in Zambia and Ghana. At individual and community levels, DISCOVER engaged peer mentors and recruited/trained community health workers to increase PrEP uptake. Interventions at the facility level included locating clinics according to client preference and offering triple case management for children and caregivers. In Ghana, we implemented interventions at the facility and individual levels that included new treatment and medication refill sites to increase client access, and walk-in ART service provision.

LESSONS LEARNED: Applying behavioral science to operationalize interventions using the PCC framework improves the uptake of HIV commodities and treatment. In Zambia, a supportive environment for PrEP uptake resulted in an increase of AGYW initiating PrEP from 39% in Q4 2020 to 61% in Q3 2021. A cohort analysis found continuity of treatment of 95% one year after initiation and 93% two years after initiation. In Ghana, the treatment interruption rate reduced from 21% in December 2019 to 1% in June 2021.
CONCLUSIONS: The framework helps practitioners operationalize PCC to transform HIV prevention and treatment strategies conjunctively across socio-ecological levels. It can inform future strategies in Zambia, Ghana and other countries, and leverage lessons from other health areas for HIV program innovation.

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