People do not all need the same visit schedule or service setting. Differentiated service delivery, often shortened to DSD, simplifies and adapts HIV services to better meet different clinical and everyday needs.
QUICK COMPARISON
The four common questions used to design DSD
A service can adapt one or several dimensions according to clinical needs and local guidance.
| Question | Examples | Why it may help |
|---|---|---|
| When? | Longer refill intervals or appointment times outside work hours | Fewer unnecessary trips and easier continuity |
| Where? | Clinic, community point, pharmacy, mobile service or telehealth | Care closer to where people live |
| Who? | Clinician, nurse, pharmacist, trained peer or coordinated team | Uses skills efficiently while preserving referral |
| What? | A tailored package based on prevention, treatment and other health needs | Avoids both under-service and unnecessary visits |
01
DSD is not lower-quality care
WHO defines differentiated delivery as a person-centred approach that simplifies and adapts services across the HIV cascade. It does not remove clinical safeguards. People with new symptoms, treatment problems, a high viral load or complex needs may require more intensive care, while others may safely need fewer facility visits.
02
The model can apply beyond stable ART
DSD began with major attention to treatment refills and follow-up, but its principles can also support testing, linkage, PrEP and integrated care. Examples include community medicine pickup, multi-month dispensing, peer-supported services and differentiated PrEP follow-up.
03
The right model depends on the person and context
A convenient model for one person may create risk or difficulty for another. Privacy at a community pickup point, digital access for telehealth, travel distance, disability, work schedules, family responsibilities and clinical status should all be considered.
04
Ask how the service handles change
A strong DSD programme explains who is eligible, what monitoring continues, how to contact the team, and how someone can move to more or less intensive care when their needs change.
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Guides for your next step
FAQ
Frequently asked questions
Does DSD mean fewer HIV services?
Not necessarily. It means the frequency, location, provider or package is adapted. Some people need less frequent visits; others need more support.
Can PrEP services be differentiated?
Yes. WHO guidance describes person- and community-centred PrEP delivery adapted to the needs and preferences of people who could benefit.
Is telehealth always part of DSD?
No. Telehealth is one possible tool. Community pickup, pharmacy delivery, flexible hours and multi-month refills are other examples.
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AUTHOR
Numcha Editorial Team
Public-health content teamThe Numcha Editorial Team turns primary public-health guidance into clear, respectful information for people across Southeast Asia.
CONTENT REVIEW
Numcha Editorial Review
Source and safety reviewThis review checks health claims against named public-health sources. Country-specific clinical pathways should also be confirmed locally.
Source and safety review completed 5 September 2026. Confirm service details with a local provider before making decisions.
SOURCE AND REVIEW
Built from primary public-health guidance.
This article provides general information and does not replace an individual medical assessment, especially for urgent situations or medicine decisions.