How health care facility characteristics affect HIV viral suppression among NYC patients

Health care facility characteristics such as the type of clinical setting, the travel distance from the patient's home, the support services offered, and physician experience have been shown to influence health outcomes among persons with HIV, but few studies have explored how these factors influence HIV viral suppression among patients.

To test the association of these characteristics with the achievement and maintenance of HIV suppression among newly-diagnosed New York City residents, CUNY SPH doctoral alumna Ellen Wiewel—now the director of research and evaluation at the New York City Department of Health and Mental Hygiene's Housing Services Unit—led a study with CUNY SPH faculty, published in the journal AIDS Care.

The researchers applied multivariable proportional hazards models to patient and facility data from the NYC HIV Surveillance Registry to compare individual achievement and maintenance of viral suppression by type of facility, patient volume, and distance from residence.

The study found that patients at facilities with higher HIV-positive caseloads achieved and maintained viral suppression the most. Facilities with small caseloads and screening/diagnosis sites may need stronger care or referral systems to help persons with HIV achieve and maintain viral suppression.

"State and federal HIV plans call for increased rates of HIV viral suppression, and most people who live with HIV have daily medication that's supposed to help them achieve viral suppression," says Wiewel. "Our analysis suggested that assisting people with HIV to attend large healthcare facilities, or supporting smaller facilities to strengthen their services or referral systems, may help end the epidemic by increasing the rates of HIV viral suppression."