Screen | Overall purpose of screen | Reasons for screening out | Justification | If screen out, anticipated next step |
Symptom report | Identify self-reported conditions that require additional investigation | Current cough, fever, night sweats or recent weight loss | These symptoms comprise the WHO-recommended TB symptom screen16 | Referral for TB test |
Persistent headache for >2 days | Symptom of cryptococcal meningitis17 18 | Referral for CrAg screening | ||
Other self-reported symptoms | Other symptoms could indicate the need for further clinical investigation | Referral for additional clinical consultation | ||
Medical history | Through self-report identify individuals on concurrent medications or who may struggle with adherence | On ART previously | Patients who have been on ART in the past may require additional adherence counselling | Referral for additional counselling session |
Started TB treatment within the past 2 weeks | Guidelines recommend a 2-week delay in ART initiation for patients starting TB treatment | Appointment for ART initiation immediately after the 2-week window has passed | ||
Concurrent medications for epilepsy or current warfarin | These medications can interact with ARVs | Referral for additional clinical or pharmacy consultation | ||
Current substance abuse | Use of recreational drugs or overuse of alcohol can create challenges for chronic medication adherence | Referral for additional counselling session | ||
Physical examination | Record weight, height, temperature and blood pressure and identify any observable conditions that require additional investigation | Any conditions that call for further investigation prior to ART initiation | Patient may identify previously unreported symptoms or clinician may observe conditions that indicate a need for further clinical investigation before starting ART | Referral for additional clinical consultation |
Readiness assessment | Confirm that the patient feels ready to start ART today | Responses that indicate reluctance, hesitation or concerns in starting and adhering to treatment | Creates a structured opportunity for clinician and patient to discuss any concerns that the patient has not yet raised | Referral for additional counselling and follow-up support as indicated |
ART, antiretroviral therapy; CrAg, cryptococcal antigen; SLATE, Simplified Algorithm for Treatment Eligibility; TB, tuberculosis.