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The Article in Brief
A Population-Based Study Evaluating Family Physicians' HIV Experience and Care of People Living With HIV in Ontario
Claire Kendall , and colleagues
Background Antiretroviral therapy (ART) for HIV infection has reduced death and disease and shifted the care needs of people living with long-term HIV. Early studies found that clinicians with more training and/or experience in HIV provided higher quality of care, but as the disease and treatments become less novel and complex, quality of HIV care between generalist and specialist physicians has become more similar. This 4-year study explores whether the HIV experience of family physicians effects the association between model of care delivery and the quality of care for people living with HIV.
What This Study Found Family doctors who take care of more HIV-positive patients in their regular practice are more likely to follow antiretroviral therapy protocols than other family doctors. Among more than 13,000 HIV-positive patients, the majority saw family physicians exclusively for their care. Those who saw a family physician with the highest level of HIV experience were almost twice as likely to receive ART than those seeing less experienced family physicians. Cancer screening and health service use were not influenced by family physician HIV experience. The influence of family physician HIV experience appears to be mitigated by having an HIV specialist in the model of care.
Implications
- The authors conclude that to ensure adequate ART prescribing, care delivery models for people with HIV should include either an HIV specialist or a family physician with considerable HIV experience.