BC-CfE Looks at Patient-Physician Relationships to Improve HIV Outcomes

Dr. Lianping Ti, a Research Scientist for the BC Centre for Excellence in HIV/AIDS (BC-CfE) and an Assistant Professor in the Division of AIDS at the University of British Columbia Department of Medicine will present her latest research at the 2016 International AIDS Society conference in Durban, South Africa, July 21, 2016. The research examines whether patient-physician relationships can play a role in improving HIV treatment outcomes among people living with HIV (PLHIV).

In June 2016, the United Nations and Member States formally endorsed the BC-CfE’s 90-90-90 global treatment target, which proposes that by 2020 we should have 90% of infected people globally aware of their status, 90% of known positives on HIV treatment, and 90% of those on treatment with the amount of virus in their bloodstream decreased to undetectable levels. This will, in turn, decrease the burden of HIV-related disease (i.e., morbidity, mortality and new infections) by 90% by 2030.

Within this context, Dr. Ti’s paper entitled “The impact of patient-provider attachment on HIV-1 RNA plasma viral load suppression among people living with HIV/AIDS in British Columbia” was made possible by the B.C. Ministry of Health-funded ‘Seek and Treat for Optimal Prevention of HIV & AIDS’ pilot project led by Dr. Julio Montaner, Director of the BC-CfE. Funding was also provided through an Avant-Garde Award and funding from the National Institute of Drug Abuse (NIDA), at the US National Institutes of Health (NIH).

The BC-CfE spoke with Dr. Ti about her work.

BC-CfE: Who took part in the study and how were you able to measure treatment outcomes?

Dr. Ti: We used a dataset of non-identifiable people living with HIV (PLHIV) in B.C. through health administrative databases.

BC-CfE: What is the most important message you found regarding physician-patient relationships and its impact on HIV treatment outcomes in your study?

Dr. Ti: We found patients who had a higher level of engagement with the same provider for HIV-related services were more likely to achieve viral load (VL) suppression. This leads us to believe continuity of care between patients and their providers contributes to optimized HIV treatment outcomes in this setting.

BC-CfE: What else can HIV treatment providers learn from this study?

Dr. Ti: As HIV becomes managed as a chronic disease and PLHIV experience multiple complex comorbidities such as addiction, viral hepatitis and mental health issues, frequent contact with a physician will be needed in order to achieve optimum health outcomes. In light of this, health care providers should be supported to adopt a patient-centred care approach that incorporates the patient’s belief systems about HIV/AIDS, medications, comorbidities and healthcare utilization into discussions around how to most effectively achieve VL suppression.

BC-CfE: How can this information be used to reach the 90-90-90 Target goals?

Dr. Ti: The present study adds to the current literature by demonstrating through population-level administrative data that having strong patient-provider engagement throughout the HIV care continuum may have a beneficial impact on VL suppression among PLHIV. Interventions that aim to build these relationships may assist in achieving the 90-90-90 Target set out by UNAIDS.

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