MSF has implemented a pilot of medication adherence clubs (MACs) in Kibera, Kenya. MACs build on ART adherence clubs by incorporating stable clients with hypertension and diabetes mellitus. MACs meet 4 times per year (every 3 months) for 90-120 minutes and are led by lay health care workers. Pre-packed medication is distributed. Clients have an annual viral load and clinical review that aligns with their MAC visit dates. Those with a high viral load are recalled to visit the facility on a separate date.