Primary healthcare providers perspectives on six-month dispensing of HIV medication in South Africa: a cross-sectional survey

BackgroundIn many African countries the dispensing duration for antiretroviral therapy (ART) medication for HIV treatment has increased from 3 months to 6 months for stable clients. To help inform a decision about whether to move from three-month dispensing (3MMD) to six-month dispensing (6MMD) in South Africa, we surveyed healthcare providers about their perspectives on dispensing and scripting durations. MethodsWe conducted a cross-sectional survey of healthcare providers (nurses, managers, pharmacists) at 24 primary healthcare clinics in South Africa from May to September 2024, asking closed- and open-ended questions. Results are reported as frequencies. Results182 providers were enrolled from four provinces (median age 44, 88% female). Most (>70%) respondents said that the 3MMD guideline offered multiple benefits for providers and patients, compared to the previous two-month dispensing rule; most (64%) also said there were no challenges in implementing 3MMD. >80% of respondents across all cadres reported that they would be comfortable dispensing 6 months of ART at a time, believing that it would reduce facility overcrowding, lighten staff workloads, and be advantageous to clients by decreasing their visit burden and travel costs. Two thirds (63%) of participating nurses, who provide the largest share of direct ART care, were also in favour of resuming 12-month scripting for ART; the remaining 37% expressed concerns about decreases in treatment adherence and clinical monitoring of clients. ConclusionMost healthcare providers at primary healthcare clinics in South Africa are in favour of allowing six-month dispensing and 12-month prescriptions as options for established ART clients.