Ofer Amram1, Lu Wang2, Paul Sereda2, Jean A Shoveller3, Rolando Barrios3, Julio S G Montaner4, Viviane D Lima3. 1. Spokane Health Education and Research Building Third Floor, P O Box 1495 , Spokane, WA 99210-1495. Epidemiology and Population Health Program, British Columbia Centre for Excellence in HIV/AIDS. Department of Nutrition and Exercise Physiology, Elson S. Floyd College of Medicine, Washington State University. 2. Epidemiology and Population Health Program, British Columbia Centre for Excellence in HIV/AIDS. 3. Epidemiology and Population Health Program, British Columbia Centre for Excellence in HIV/AIDS. Division of AIDS, Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada. 4. British Columbia Centre for Excellence in HIV/AIDS. Division of AIDS, Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Abstract
OBJECTIVES: In 2014, the Joint United Nations Programme HIV/AIDS (UNAIDS) set the target of dramatically reducing the burden of HIV through expansion of access to timely HIV treatment. In order to achieve this target it is necessary to expand access to care along the HIV cascade of care. This study examines the relationship between viral suppression and the availability of physicians providing HIV treatment in British Columbia, Canada. METHODS: Data from the Drug Treatment Program of the British Columbia (BC) Centre for Excellence in HIV/AIDS was used for this analysis. The floating catchment method was used to assess physician availability. Multivariable Logistic Regression was used to implement a confounder selection technique to independently assess the relationship between physician availability and viral load suppression. RESULTS: Individuals with more than 25 physicians within a one-hour catchment were more likely to reside in urban areas and almost twice as likely to have a suppressed viral load (adjusted odd ratio: 1.97; 95% CI 1.50 - 2.58). CONCLUSIONS: This study highlights the impact of physicians' availability on viral load levels. Mapping technology was used to identify the locations in which patients were most impacted by the lack of physicians.
OBJECTIVES: In 2014, the Joint United Nations Programme HIV/AIDS (UNAIDS) set the target of dramatically reducing the burden of HIV through expansion of access to timely HIV treatment. In order to achieve this target it is necessary to expand access to care along the HIV cascade of care. This study examines the relationship between viral suppression and the availability of physicians providing HIV treatment in British Columbia, Canada. METHODS: Data from the Drug Treatment Program of the British Columbia (BC) Centre for Excellence in HIV/AIDS was used for this analysis. The floating catchment method was used to assess physician availability. Multivariable Logistic Regression was used to implement a confounder selection technique to independently assess the relationship between physician availability and viral load suppression. RESULTS: Individuals with more than 25 physicians within a one-hour catchment were more likely to reside in urban areas and almost twice as likely to have a suppressed viral load (adjusted odd ratio: 1.97; 95% CI 1.50 - 2.58). CONCLUSIONS: This study highlights the impact of physicians' availability on viral load levels. Mapping technology was used to identify the locations in which patients were most impacted by the lack of physicians.
Authors: Syed Morad Hameed; Nadine Schuurman; Tarek Razek; Darrell Boone; Rardi Van Heest; Tracey Taulu; Nasira Lakha; David C Evans; D Ross Brown; Andrew W Kirkpatrick; Henry T Stelfox; Dianne Dyer; Mary van Wijngaarden-Stephens; Sarvesh Logsetty; Avery B Nathens; Tanya Charyk-Stewart; Sandro Rizoli; Lorraine N Tremblay; Frederick Brenneman; Najma Ahmed; Elsie Galbraith; Neil Parry; Murray J Girotti; Guiseppe Pagliarello; Nancy Tze; Kosar Khwaja; Natalie Yanchar; John M Tallon; J Andrew I Trenholm; Candance Tegart; Ofer Amram; Myriam Berube; Usmaan Hameed; Richard K Simons Journal: J Trauma Date: 2010-12
Authors: Viviane D Lima; Josie Geller; David R Bangsberg; Thomas L Patterson; Mark Daniel; Thomas Kerr; Julio S G Montaner; Robert S Hogg Journal: AIDS Date: 2007-05-31 Impact factor: 4.177