Once people seroconvert, they are more likely to be virally suppressed and have higher trough CD4 cell counts if they see the same health care provider over time, an analysis of data from the Illinois Medical Monitoring Project published in The American Journal of Managed Care showed.
The data were derived from 1,584 people in Illinois who were participants in a Centers for Disease Control and Prevention-sponsored supplemental surveillance system that combined interviews with medical record abstractions. Of those 1,584 people, only 537 (34%) answered interview questions that specifically focused on consistency in HIV care providers. All participants received HIV medical treatment.
The study found that 79% of participants were virally suppressed (per their most recent test result) and 85% had a CD4 count of 200 or higher. People who reported having a consistent HIV health care provider were four times as likely to be virally suppressed and to have a CD4 count of 200 or higher compared to those who reported not having a consistent HIV health care provider.
Seeing the same health care professional at each visit not only improves the patient-provider relationship, but also means consistent health care access, which in itself may improve overall health, study authors noted.
HIV outcomes were also better among those living in Chicago compared to the rest of the state, likely due to better access to services and transportation. Conversely, outcomes were worse among heterosexuals compared to MSM, possibly because of the relative dearth of HIV prevention and treatment programs intended for straight people, study authors wrote.
In addition, as shown in other studies, unmet social needs were associated with worse HIV outcomes. Unsurprisingly, race, age, and health insurance access also factored into outcomes, with Black participants faring worse than non-Black participants and younger participants faring worse than older participants.
The study authors recommended policy interventions to ensure consistent patient-provider relationships, social services to address non-medical needs, and programs targeted at heterosexuals.