Do HIV Care Outcomes Differ by Provider Type?

Area of Science:

• Public Health
• Infectious Diseases
• Healthcare Management

Background:

• HIV care outcomes are influenced by the healthcare provider workforce.
• Understanding differences in outcomes by provider type is crucial for optimizing HIV care delivery.

Purpose of the Study:

• To compare human immunodeficiency virus (HIV) care outcomes across different types of HIV providers.
• To inform strategies for strengthening the HIV provider workforce.

Main Methods:

• Analysis of data from the CDC's Medical Monitoring Project (2019-2021) involving 6323 adults.
• Categorization of providers into infectious disease (ID) physicians only, non-ID physicians only, nurse practitioners only, physician assistants only, and mixed provider groups.
• Measurement of patient characteristics, social determinants of health, and clinical outcomes including retention, ART adherence, viral suppression, STI testing, and patient satisfaction.

Main Results:

• While patients of non-ID physicians, nurse practitioners, and mixed providers had higher retention in care and sexually transmitted infection (STI) testing rates, most other HIV outcomes were comparable across provider types.
• Patients receiving care from non-ID physicians, nurse practitioners, and mixed provider teams showed statistically significant improvements in retention and STI testing.

Conclusions:

• HIV care outcomes are largely equivalent across various provider types.
• Non-ID physicians, nurse practitioners, and mixed provider teams demonstrate enhanced performance in patient retention and STI testing.
• Integrating comprehensive primary care into ID practices and involving primary care providers can potentially improve overall HIV primary care outcomes.