Background: Fast Track (FT) is an accelerated drug pick-up model where stable HIV positive patients are given three rather than one month of ART supply through a dedicated treatment room. FT was piloted in two primary health centres in Lusaka, Zambia, to explore feasibility and effectiveness in improving patient retention. We sought to understand the experiences of health care workers (HCW) and patients after approximately six months of implementation to identify needed improvements or midcourse changes.
Methods: From January-March 2017, we conducted an exploratory qualitative study using six Focus Group Discussions (FGDs) with patients and eight In-depth interviews (IDIs) with HCW''s to collect data on their lived experiences with the FT model. All interviews and discussions were audio-recorded using a voice recorder and transcribed into English. Thematic analysis was conducted using Nvivo 11.
Results: Both HCW and patients viewed FT as having the ability to decongest the clinic by spacing ART pick-ups and reducing time spent in the clinic by providing dedicated services. The latter was reported as particularly attractive to both patients and HCWs who expressed concerns regarding patient wait times under routine care. However, patients requested that all other services such as measuring weight and blood pressure be incorporated into the dedicated service room. They also complained about long wait times during clinical visits because clinicians did not appreciate the fact that the patients had come early to the FT room. HCWs emphasized the importance of orientation and information dissemination to bring all HCWs at the facilities on board, foster a sense of ownership and to avoid patient perceptions of staff favouritism or nepotism that may negatively impact patient-provider relations. HCWs further expressed concern regarding the time allocated for adherence support during the patient pharmacy visits as the focus was only on drug pick-up.
Conclusions: Overall, the FT model was reported to be highly applicable and acceptable. The segregation of other services (e.g., weight) and clinical reviews still being offered under routine conditions made the model less attractive. A dedicated FT day may be more efficient and equitable than mixed FT and routine services.

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