The impact of integrated HIV care on patient health outcomes

Background—Control of viral replication through combination antiretroviral therapy (cART) improves patient health outcomes. Yet many HIV-infected patients have co-morbidities that pose social and clinical barriers to achieving viral suppression. Integration of subspecialty services into HIV primary care may overcome such barriers. Objective—Evaluate effect of Integrated HIV Care on suppression of HIV replication. Research Design—A retrospective cohort study of HIV patients from five Veterans Affairs healthcare facilities 2000–2006. Subjects—Patients with >3 months of follow-up, sufficient baseline HIV severity, on cART. Measures—We measured and ranked Integrated Care at the facilities. These rankings were applied to patient visits to form an index of Integrated HIV Care utilization. We evaluated effect of Integrated HIV Care utilization on likelihood of achieving viral suppression while on cART, controlling for demographic and clinical factors using survival analysis.