Key findings
-  When antiretroviral therapy (ART) was started at a hospital and continued in a health centre (partial decentralisation), there was probably less attrition and fewer patients were lost to care after one year.
-  Where ART was started and continued at a health centre (full decentralisation), there was probably no difference in the number of deaths and patients lost to follow-up (attrition), but overall, there were probably fewer patients lost to care after one year .
-  When ART was provided in the community, by trained volunteers, there was no difference detected in death or losses to care when compared to care provided at a 
health centre after one year.

Many people living with HIV who need ART are unable to access or remain in care. This is often because of the time and cost required to travel to health centres. One approach to facilitating access and retention in care is to provide ART close to people’s homes, ‘decentralising’ treatment from hospitals to health centres or even to the community.