HIV caseload increasing among primary care providers

Primary care providers (PCPs) are increasingly caring for and treating people living with HIV, according to the HealthHIV State of HIV Primary Care survey released today.

In the first major survey of its kind, 54% of primary care providers report treating HIV positive patients, with 43% indicating their HIV caseload “increased” or “increased dramatically” during the past year. Over half of the PCPs responding (55%) believe they are capable of providing a “medical home” (i.e. one location offering integrated health services) to HIV positive individuals.

“The state of HIV primary care is evolving rapidly, with serious implications for the healthcare system,” said HealthHIV Executive Director Brian Hujdich. “This survey shows the need to increase HIV-related medical education for PCPs managing HIV as a chronic disease in the medical home setting. Innovative, cost-effective approaches using new technologies are required to enhance the PCPs ability to offer quality HIV care.”

The survey reveals that, among HIV specialists, 74% report an increased HIV caseload, with 14% indicating it “increased dramatically.” Thirty-six percent of PCPs treating people living with HIV report seeing more than 200 HIV positive patients annually in their practice or organization. Among HIV specialists, 79% report an annual HIV caseload of more than 200 HIV positive patients in their practice or organization.

When asked how likely their practice or organization could accommodate newly diagnosed HIV positive individuals if proposed recommendations for routine testing are implemented, 65% of HIV PCPs respond it is “extremely likely or “very likely,” 29% indicate it is “somewhat likely,” while 6% answer it is “not at all likely.”

Regarding the feasibility of primary care organizations serving as a medical home for people living with HIV, 55% of PCPs treating HIV believe it is feasible. Interestingly, 75% of HIV specialists believe primary care organizations can feasibly serve as a medical home.

HIV specialists and HIV PCPs see a large percentage of racial and ethnic minority patients, according to the survey. Sixty-five percent of HIV specialists, and 46% of HIV PCPs, indicate that more than half their patients are people of color.

This study identifies the integral function primary care providers perform in HIV prevention, care and treatment,” said Hujdich. “These findings will help guide HealthHIV’s training, medical education, technical assistance and capacity building programs, especially in reaching medically underserved racial and ethnic communities.”

The HealthHIV State of HIV Primary Care survey collected 1,165 responses from participants in every state and territory within the United States. This benchmark survey, conducted by HealthHIV’s Health Services Research Department, will be conducted annually to identify trends in HIV provision among primary care providers and HIV specialists.

A full report will be available on HealthHIV’s website following a presentation of findings at the International AIDS Conference July 18-23, 2010 in Vienna, Austria.