HIV Standard of Care for ART Adherence and Retention in Care Among HIV Medical Care Providers Across Four CNICS Clinics in the US

Sarah Shaw, Riddhi Modi, Michael Mugavero, Carol Golin, Evelyn Byrd Quinlivan, Laramie R. Smith, Katya Roytburd, Heidi Crane, Jeanne C Keruly, Anne Zinski, K. Rivet Amico

Research output: Contribution to journalArticle

Abstract

Despite the issuance of evidence-based and evidence—informed guidelines to improve engagement in HIV care and adherence-related outcomes, few studies have assessed contemporary adherence or engagement support practices of HIV care providers in US clinics. As a result, the standard of HIV care in the US and globally remains poorly understood. This programmatic assessment approach aimed to identify the strengths and gaps in the current standard of HIV care from the perspective of HIV care providers. A self-administered Standard of Care measure was developed and delivered through Qualtrics to HIV care providers at four different HIV care sites as a part of a multisite intervention study to improve engagement in HIV care and ART adherence. Providers were asked to provide demographic and clinic specific information, identify practices/strategies applied during typical initial visits with HIV-positive patients and visits prior to and at ART initiation, as well as their perceptions of patient behaviors and adequacy of HIV care services at their clinics. Of the 75 surveys which were completed, the majority of respondents were physicians, and on average, providers have worked in HIV care for 13.5 years. Across the sites, 91% of the providers’ patient panels consist of HIV-positive patients, the majority of whom are virally suppressed and 1/5 are considered “out of care.” Few resources were routinely available to providers by other staff related to monitoring patient adherence and engagement in care. During typical initial visits with HIV positive patients, the majority of providers report discussing topics focused on behavioral/life contexts such as sexual partnerships, sexual orientation, disclosure, and other sources of social support. Nearly all providers emphasize the importance of adherence to treatment recommendations and nearly 90% discuss outcomes of good adherence and managing common side effects during ART start visits. Overall, providers do not report often implementing practices to improve retention in care. Survey results point to opportunities to enhance engagement in HIV care and improve ART adherence through systematic data monitoring and increased collaboration across providers and other clinic staff, specifically when identifying patients defined as “in need” or “out of care.” Trial Registration: Clinicaltrials.gov NCT01900236.

Original languageEnglish (US)
JournalAIDS and Behavior
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Standard of Care
HIV
Patient Participation
Disclosure
Patient Compliance
Sexual Behavior
Social Support

Keywords

  • ART adherence
  • Engagement in care
  • HIV
  • Retention
  • Standard of care

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

Cite this

HIV Standard of Care for ART Adherence and Retention in Care Among HIV Medical Care Providers Across Four CNICS Clinics in the US. / Shaw, Sarah; Modi, Riddhi; Mugavero, Michael; Golin, Carol; Quinlivan, Evelyn Byrd; Smith, Laramie R.; Roytburd, Katya; Crane, Heidi; Keruly, Jeanne C; Zinski, Anne; Amico, K. Rivet.

In: AIDS and Behavior, 01.01.2018.

Research output: Contribution to journalArticle

Shaw, Sarah ; Modi, Riddhi ; Mugavero, Michael ; Golin, Carol ; Quinlivan, Evelyn Byrd ; Smith, Laramie R. ; Roytburd, Katya ; Crane, Heidi ; Keruly, Jeanne C ; Zinski, Anne ; Amico, K. Rivet. / HIV Standard of Care for ART Adherence and Retention in Care Among HIV Medical Care Providers Across Four CNICS Clinics in the US. In: AIDS and Behavior. 2018.
@article{9b6239f2739340279adbc070812b1db0,
title = "HIV Standard of Care for ART Adherence and Retention in Care Among HIV Medical Care Providers Across Four CNICS Clinics in the US",
abstract = "Despite the issuance of evidence-based and evidence—informed guidelines to improve engagement in HIV care and adherence-related outcomes, few studies have assessed contemporary adherence or engagement support practices of HIV care providers in US clinics. As a result, the standard of HIV care in the US and globally remains poorly understood. This programmatic assessment approach aimed to identify the strengths and gaps in the current standard of HIV care from the perspective of HIV care providers. A self-administered Standard of Care measure was developed and delivered through Qualtrics to HIV care providers at four different HIV care sites as a part of a multisite intervention study to improve engagement in HIV care and ART adherence. Providers were asked to provide demographic and clinic specific information, identify practices/strategies applied during typical initial visits with HIV-positive patients and visits prior to and at ART initiation, as well as their perceptions of patient behaviors and adequacy of HIV care services at their clinics. Of the 75 surveys which were completed, the majority of respondents were physicians, and on average, providers have worked in HIV care for 13.5 years. Across the sites, 91{\%} of the providers’ patient panels consist of HIV-positive patients, the majority of whom are virally suppressed and 1/5 are considered “out of care.” Few resources were routinely available to providers by other staff related to monitoring patient adherence and engagement in care. During typical initial visits with HIV positive patients, the majority of providers report discussing topics focused on behavioral/life contexts such as sexual partnerships, sexual orientation, disclosure, and other sources of social support. Nearly all providers emphasize the importance of adherence to treatment recommendations and nearly 90{\%} discuss outcomes of good adherence and managing common side effects during ART start visits. Overall, providers do not report often implementing practices to improve retention in care. Survey results point to opportunities to enhance engagement in HIV care and improve ART adherence through systematic data monitoring and increased collaboration across providers and other clinic staff, specifically when identifying patients defined as “in need” or “out of care.” Trial Registration: Clinicaltrials.gov NCT01900236.",
keywords = "ART adherence, Engagement in care, HIV, Retention, Standard of care",
author = "Sarah Shaw and Riddhi Modi and Michael Mugavero and Carol Golin and Quinlivan, {Evelyn Byrd} and Smith, {Laramie R.} and Katya Roytburd and Heidi Crane and Keruly, {Jeanne C} and Anne Zinski and Amico, {K. Rivet}",
year = "2018",
month = "1",
day = "1",
doi = "10.1007/s10461-018-2320-1",
language = "English (US)",
journal = "AIDS and Behavior",
issn = "1090-7165",
publisher = "Springer New York",

}

TY - JOUR

T1 - HIV Standard of Care for ART Adherence and Retention in Care Among HIV Medical Care Providers Across Four CNICS Clinics in the US

AU - Shaw, Sarah

AU - Modi, Riddhi

AU - Mugavero, Michael

AU - Golin, Carol

AU - Quinlivan, Evelyn Byrd

AU - Smith, Laramie R.

AU - Roytburd, Katya

AU - Crane, Heidi

AU - Keruly, Jeanne C

AU - Zinski, Anne

AU - Amico, K. Rivet

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Despite the issuance of evidence-based and evidence—informed guidelines to improve engagement in HIV care and adherence-related outcomes, few studies have assessed contemporary adherence or engagement support practices of HIV care providers in US clinics. As a result, the standard of HIV care in the US and globally remains poorly understood. This programmatic assessment approach aimed to identify the strengths and gaps in the current standard of HIV care from the perspective of HIV care providers. A self-administered Standard of Care measure was developed and delivered through Qualtrics to HIV care providers at four different HIV care sites as a part of a multisite intervention study to improve engagement in HIV care and ART adherence. Providers were asked to provide demographic and clinic specific information, identify practices/strategies applied during typical initial visits with HIV-positive patients and visits prior to and at ART initiation, as well as their perceptions of patient behaviors and adequacy of HIV care services at their clinics. Of the 75 surveys which were completed, the majority of respondents were physicians, and on average, providers have worked in HIV care for 13.5 years. Across the sites, 91% of the providers’ patient panels consist of HIV-positive patients, the majority of whom are virally suppressed and 1/5 are considered “out of care.” Few resources were routinely available to providers by other staff related to monitoring patient adherence and engagement in care. During typical initial visits with HIV positive patients, the majority of providers report discussing topics focused on behavioral/life contexts such as sexual partnerships, sexual orientation, disclosure, and other sources of social support. Nearly all providers emphasize the importance of adherence to treatment recommendations and nearly 90% discuss outcomes of good adherence and managing common side effects during ART start visits. Overall, providers do not report often implementing practices to improve retention in care. Survey results point to opportunities to enhance engagement in HIV care and improve ART adherence through systematic data monitoring and increased collaboration across providers and other clinic staff, specifically when identifying patients defined as “in need” or “out of care.” Trial Registration: Clinicaltrials.gov NCT01900236.

AB - Despite the issuance of evidence-based and evidence—informed guidelines to improve engagement in HIV care and adherence-related outcomes, few studies have assessed contemporary adherence or engagement support practices of HIV care providers in US clinics. As a result, the standard of HIV care in the US and globally remains poorly understood. This programmatic assessment approach aimed to identify the strengths and gaps in the current standard of HIV care from the perspective of HIV care providers. A self-administered Standard of Care measure was developed and delivered through Qualtrics to HIV care providers at four different HIV care sites as a part of a multisite intervention study to improve engagement in HIV care and ART adherence. Providers were asked to provide demographic and clinic specific information, identify practices/strategies applied during typical initial visits with HIV-positive patients and visits prior to and at ART initiation, as well as their perceptions of patient behaviors and adequacy of HIV care services at their clinics. Of the 75 surveys which were completed, the majority of respondents were physicians, and on average, providers have worked in HIV care for 13.5 years. Across the sites, 91% of the providers’ patient panels consist of HIV-positive patients, the majority of whom are virally suppressed and 1/5 are considered “out of care.” Few resources were routinely available to providers by other staff related to monitoring patient adherence and engagement in care. During typical initial visits with HIV positive patients, the majority of providers report discussing topics focused on behavioral/life contexts such as sexual partnerships, sexual orientation, disclosure, and other sources of social support. Nearly all providers emphasize the importance of adherence to treatment recommendations and nearly 90% discuss outcomes of good adherence and managing common side effects during ART start visits. Overall, providers do not report often implementing practices to improve retention in care. Survey results point to opportunities to enhance engagement in HIV care and improve ART adherence through systematic data monitoring and increased collaboration across providers and other clinic staff, specifically when identifying patients defined as “in need” or “out of care.” Trial Registration: Clinicaltrials.gov NCT01900236.

KW - ART adherence

KW - Engagement in care

KW - HIV

KW - Retention

KW - Standard of care

UR - http://www.scopus.com/inward/record.url?scp=85055979375&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85055979375&partnerID=8YFLogxK

U2 - 10.1007/s10461-018-2320-1

DO - 10.1007/s10461-018-2320-1

M3 - Article

C2 - 30377981

AN - SCOPUS:85055979375

JO - AIDS and Behavior

JF - AIDS and Behavior

SN - 1090-7165

ER -