Multi Month Scripting and Dispensing (MMSD) is an EQUIP programme that seeks to address retention and adherence support. This method of differentiated ART delivery supports countries by decreasing the burden on health facilities while increasing HIV/AIDS treatment initiation, patient retention and disease suppression.

BY identifying the total number of newly identified HIV positive patients starting ART, as well as the number of stable patients (eligible for MMSD) EQUIP is able to determine the number of ART treatments needed to implement its programme support.

Countries in low-resource settings have challenges with regards to providing patients with longer refills Having access to only a one-month supply of ART led to reduced retention of ART among patients, a barrier to treatment that EQUIP is addressing through its MMSD programme. The gains of MMSD , or differentiated ART delivery, need to be maximised in-country in order to strengthen health systems, procurement and supply chain in health facilities.

The main purpose of differentiating ART delivery, or MMSD, is to better provide for the patient’s specific needs at a particular point along their continuum of care. Each EQUIP supported country however may have different challenges and contextual influences such as key populations.

Key populations are disproportionately affected by HIV, but under-represented in HIV treatment programmes. This is partly due to stigma and discrimination experienced when accessing facility-based services. Treatment outcomes may be improved by reducing the frequency of clinical review visits and facilitating ART refill collection within key population communities or at community sites where key population members feel comfortable. Task shifting ART refill visits to key population peers can increase involvement of key population communities and organizations and also support improved outcomes.

With EQUIP’s expertise and support, supported countries can then identify the ART treatments required initially, as well as in the future. The aim is to empower countries to estimate the number of ARVs needed to transition a country’s care and treatment programmes from monthly prescribing to longer refills of, for example, two- three-, four- and six-month prescriptions in MMSD programmes.