6 research outputs found
Non-Communicable Disease Preventive Screening by HIV Care Model
<div><p>Importance</p><p>The Human Immunodeficiency Virus (HIV) epidemic has evolved, with an increasing non-communicable disease (NCD) burden emerging and need for long-term management, yet there are limited data to help delineate the optimal care model to screen for NCDs for this patient population.</p><p>Objective</p><p>The primary aim was to compare rates of NCD preventive screening in persons living with HIV/AIDS (PLWHA) by type of HIV care model, focusing on metabolic/cardiovascular disease (CVD) and cancer screening. We hypothesized that primary care models that included generalists would have higher preventive screening rates.</p><p>Design</p><p>Prospective observational cohort study.</p><p>Setting</p><p>Partners HealthCare System (PHS) encompassing Brigham & Women’s Hospital, Massachusetts General Hospital, and affiliated community health centers.</p><p>Participants</p><p>PLWHA age >18 engaged in active primary care at PHS.</p><p>Exposure</p><p>HIV care model categorized as infectious disease (ID) providers only, generalist providers only, or ID plus generalist providers.</p><p>Main Outcome(s) and Measures(s)</p><p>Odds of screening for metabolic/CVD outcomes including hypertension (HTN), obesity, hyperlipidemia (HL), and diabetes (DM) and cancer including colorectal cancer (CRC), cervical cancer, and breast cancer.</p><p>Results</p><p>In a cohort of 1565 PLWHA, distribution by HIV care model was 875 ID (56%), 90 generalists (6%), and 600 ID plus generalists (38%). Patients in the generalist group had lower odds of viral suppression but similar CD4 counts and ART exposure as compared with ID and ID plus generalist groups. In analyses adjusting for sociodemographic and clinical covariates and clustering within provider, there were no significant differences in metabolic/CVD or cancer screening rates among the three HIV care models.</p><p>Conclusions</p><p>There were no notable differences in metabolic/CVD or cancer screening rates by HIV care model after adjusting for sociodemographic and clinical factors. These findings suggest that HIV patients receive similar preventive health care for NCDs independent of HIV care model.</p></div
Odds of comparative diabetes screening events by specific screening types (A1C vs. fasting glucose).
<p>Odds ratios and 95% confidence intervals are shown for for unadjusted and adjusted analyses.</p
Metabolic/CVD and Cancer Screening Rates by HIV Care Model.
<p>Metabolic/CVD and Cancer Screening Rates by HIV Care Model.</p
Cohort Development.
<p>The flowchart indicates specific exclusion criteria applied in a stepwise manner to develop the final cohort for the study.</p
Odds of non-communicable disease screening events comparing ID plus generalist and generalist groups to ID group.
<p>Panel A shows odds of metabolic/CVD screening. Panel B shows odds of cancer screening rates. Odds ratios and 95% confidence intervals are shown for unadjusted and adjusted analyses.</p
Cohort Demographic and Clinical Characteristics.
<p>Cohort Demographic and Clinical Characteristics.</p