Department of Applied Health Science, School of Public Health, Indiana University, 1025 E 7th St, SPH 116, Bloomington, IN 47405-7129. Email:
Am J Manag Care. 2020 Jul;26(7):288-294. doi: 10.37765/ajmc.2020.43758.
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.
This was a multiyear cross-sectional observational study using secondary data.
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.
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).
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.
寻求一致的艾滋病毒保健服务对于实现预期的临床结果至关重要,因为抗逆转录病毒疗法可防止艾滋病毒繁殖并减少机会性感染。然而,是否有一个一致的艾滋病毒保健服务提供者与理想的临床结果相关仍不清楚。本研究调查了拥有一致的艾滋病毒保健服务提供者与艾滋病毒相关临床结果之间的关联。
这是一项使用二次数据的多年度横断面观察性研究。
共纳入 1584 名接受艾滋病毒保健服务的艾滋病毒感染者/艾滋病患者(PLWHA),他们参加了 2009 年至 2014 年伊利诺伊州医疗监测项目。进行了两次逻辑回归分析,以检查拥有一致的艾滋病毒保健服务提供者与 2 项临床艾滋病毒结果(病毒抑制和高 CD4 细胞计数)之间的关联。应用逆概率加权法解决了关于患者是否有一致的艾滋病毒保健服务提供者的潜在缺失数据问题。
与没有一致的艾滋病毒保健服务提供者的患者相比,有一致的艾滋病毒保健服务提供者的患者更有可能实现艾滋病毒病毒抑制(即病毒载量<200 个细胞/毫米 3)和高 CD4 细胞计数(即 CD4 ≥200 个细胞/毫米 3)(比值比分别为 4.10 和 4.18;均 P<0.05)。
在 PLWHA 中,拥有一致的艾滋病毒保健服务提供者与实现理想的艾滋病毒临床结果的可能性更高。为了优化这些结果,需要对 PLWHA 进行政策和教育干预,以使其拥有一致的艾滋病毒保健服务提供者,并建立长期、一致的医患关系。