Zhi Wang, Hsien-Chang Lin1. 1. Department of Applied Health Science, School of Public Health, Indiana University, 1025 E 7th St, SPH 116, Bloomington, IN 47405-7129. Email: linhsi@indiana.edu.
Abstract
OBJECTIVES: Seeking consistent HIV health care is essential for achieving expected clinical outcomes, as antiretroviral therapy prevents HIV from reproduction and decreases opportunistic infections. However, whether having a consistent HIV health care provider is associated with desirable clinical outcomes remained unclear. This study examined the association of having a consistent HIV health care provider and HIV-related clinical outcomes. STUDY DESIGN: This was a multiyear cross-sectional observational study using secondary data. METHODS: A total of 1584 people living with HIV/AIDS (PLWHA) and receiving HIV health care who participated in the Illinois Medical Monitoring Project from 2009 to 2014 were included. Two logistic regressions were conducted to examine the associations of having a consistent HIV health care provider and 2 clinical HIV outcomes, viral suppression and high CD4 cell count. The inverse probability weighting method was applied to address the potential issue of missing data about whether a patient had a consistent HIV health care provider. RESULTS: Patients who had a consistent HIV health care provider, compared with those who did not, had higher odds of achieving HIV viral suppression (ie, viral load < 200 cells/mm3) and of having high counts of CD4 cells (ie, CD4 ≥ 200 cells/mm3) (odds ratios, 4.10 and 4.18, respectively; both P < .05). CONCLUSIONS: Having a consistent HIV health care provider was associated with a higher likelihood of achieving desirable HIV clinical outcomes among PLWHA. To optimize these outcomes, policy and educational interventions are needed for PLWHA to have consistent HIV health care providers and to establish long-term, consistent physician-patient relationships.
OBJECTIVES: Seeking consistent HIV health care is essential for achieving expected clinical outcomes, as antiretroviral therapy prevents HIV from reproduction and decreases opportunistic infections. However, whether having a consistent HIV health care provider is associated with desirable clinical outcomes remained unclear. This study examined the association of having a consistent HIV health care provider and HIV-related clinical outcomes. STUDY DESIGN: This was a multiyear cross-sectional observational study using secondary data. METHODS: A total of 1584 people living with HIV/AIDS (PLWHA) and receiving HIV health care who participated in the Illinois Medical Monitoring Project from 2009 to 2014 were included. Two logistic regressions were conducted to examine the associations of having a consistent HIV health care provider and 2 clinical HIV outcomes, viral suppression and high CD4 cell count. The inverse probability weighting method was applied to address the potential issue of missing data about whether a patient had a consistent HIV health care provider. RESULTS:Patients who had a consistent HIV health care provider, compared with those who did not, had higher odds of achieving HIV viral suppression (ie, viral load < 200 cells/mm3) and of having high counts of CD4 cells (ie, CD4 ≥ 200 cells/mm3) (odds ratios, 4.10 and 4.18, respectively; both P < .05). CONCLUSIONS: Having a consistent HIV health care provider was associated with a higher likelihood of achieving desirable HIV clinical outcomes among PLWHA. To optimize these outcomes, policy and educational interventions are needed for PLWHA to have consistent HIV health care providers and to establish long-term, consistent physician-patient relationships.
Authors: Joseph S Lightner; Travis Barnhart; Jamie Shank; Debbie Adams; Ella Valleroy; Steven Chesnut; Serena Rajabiun Journal: PLoS One Date: 2022-09-16 Impact factor: 3.752