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ASSESSING THE RELATIONSHIP BETWEEN PHYSICIAN AVAILABILITY AND VIRAL LOAD SUPPRESSION IN BRITISH COLUMBIA

Ofer Amram1, Lu Wang2, Paul Sereda2

  • 1Spokane 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.

The Canadian Geographer. Geographe Canadien
|December 4, 2018
PubMed

Insights

Increased physician availability for HIV treatment is linked to higher rates of viral suppression. This finding emphasizes the importance of accessible healthcare providers in managing HIV care, particularly in urban British Columbia.

Area of Science:

  • Public Health
  • Epidemiology
  • Health Services Research

Background:

  • The Joint United Nations Programme on HIV/AIDS (UNAIDS) aims to reduce the global burden of HIV by expanding access to timely treatment.
  • Achieving HIV treatment targets necessitates improved access to care throughout the HIV cascade of care.
  • Physician availability is a critical, yet often overlooked, factor in patient access to HIV treatment.

Purpose of the Study:

  • To investigate the association between the availability of physicians providing HIV treatment and viral suppression rates in British Columbia, Canada.
  • To identify geographical disparities in physician access and their impact on HIV treatment outcomes.

Main Methods:

  • Utilized data from the British Columbia Centre for Excellence in HIV/AIDS Drug Treatment Program.
  • Employed the floating catchment method to quantify physician availability within a one-hour travel time.
  • Conducted multivariable logistic regression analysis to assess the relationship between physician availability and viral load suppression, controlling for confounders.

Main Results:

  • Individuals with access to over 25 physicians within a one-hour catchment were more likely to reside in urban areas.
  • Greater physician availability was significantly associated with a higher likelihood of viral load suppression (adjusted odds ratio: 1.97; 95% CI 1.50 - 2.58).

Conclusions:

  • Physician availability is a significant determinant of viral load suppression in HIV-positive individuals.
  • Geospatial analysis using mapping technology can identify areas with limited physician access, highlighting critical needs for intervention.
  • Strategies to increase physician density in underserved areas are crucial for improving HIV treatment outcomes and meeting public health targets.
Abstract

Keywords:
Antiretroviral TherapyGISPhysician AvailabilityViral Load Suppression

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