Amram Ofer, Wang Lu, Sereda Paul, Shoveller Jean A, Barrios Rolando, Montaner Julio S G, Lima Viviane D
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.
Epidemiology and Population Health Program, British Columbia Centre for Excellence in HIV/AIDS.
Can Geogr. 2018 Summer;62(2):120-129. doi: 10.1111/cag.12433. Epub 2017 Dec 24.
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.
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.
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).
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.
2014年，联合国艾滋病规划署（UNAIDS）设定了通过扩大及时获得艾滋病毒治疗的机会来大幅减轻艾滋病毒负担的目标。为实现这一目标，有必要在艾滋病毒治疗连续过程中扩大护理服务的可及性。本研究考察了加拿大不列颠哥伦比亚省病毒抑制与提供艾滋病毒治疗的医生可及性之间的关系。
本分析使用了不列颠哥伦比亚省（BC）卓越艾滋病毒/艾滋病中心药物治疗项目的数据。采用浮动集水区方法评估医生可及性。使用多变量逻辑回归实施混杂因素选择技术，以独立评估医生可及性与病毒载量抑制之间的关系。
在一小时集水区内有超过25名医生的个体更有可能居住在城市地区，其病毒载量被抑制的可能性几乎是其他人的两倍（调整后的优势比：1.97；95%置信区间1.50 - 2.58）。
本研究突出了医生可及性对病毒载量水平的影响。使用地图技术确定了患者受医生短缺影响最大的地点。
