Impact of HIV care facility characteristics on the cascade of care in HIV-infected patients in the Netherlands
View abstract on PubMed
Summary
This summary is machine-generated.Health facility accreditation and size improve combination antiretroviral therapy (cART) initiation for HIV patients. Expert HIV centers enhance retention in care, but social worker presence may hinder viral suppression.
Area Of Science
- Public Health
- Infectious Diseases
- Health Services Research
Background
- Successful HIV treatment relies on patient retention, combination antiretroviral therapy (cART) use, and sustained viral suppression.
- Identifying health facility characteristics is crucial for optimizing the HIV care cascade.
Purpose Of The Study
- To identify health facility characteristics associated with patient retention in HIV care, cART initiation, and viral suppression.
- To evaluate the impact of facility accreditation, size, and internal audits on HIV care outcomes.
Main Methods
- Retrospective cohort study of 7120 adult HIV-1-infected patients in the Netherlands (2007-2013).
- Multivariate logistic regression analysis to assess associations between facility characteristics and care cascade outcomes.
Main Results
- Accreditation (OR: 1.62) and recent internal audits (OR: 1.36) positively correlated with cART initiation.
- Middle-sized (OR: 2.00) and large (OR: 1.80) HIV treatment centers showed higher cART initiation rates compared to small centers.
- Viral suppression was negatively associated with the presence of a social worker (OR: 0.62).
Conclusions
- Expert HIV treatment centers facilitate retention in care, suggesting a potential benefit from minimum volume requirements.
- Quality assessment through accreditation and performance measurement positively impacts HIV care delivery.
- Facility characteristics significantly influence patient engagement and outcomes throughout the HIV care cascade.