HIV Treatment: Why Some Health Care Facilities Have Better Outcomes

About 1.2 million Americans are living with HIV, according to the Office of Disease Prevention and Health Promotion. Suppressing the virus through medication is not only essential to surviving the disease, but it also remains a critical strategy for controlling its transmission.

But why do some health care facilities have better outcomes when it comes to treating HIV than others? Researchers from CUNY’s Graduate School of Public Health & Health Policy and the NYC Department of Health and Mental Hygiene did a study to find out. 

The researchers — SPH Professors Luisa BorrellHeidi E. Jones, and Andrew Maroko, Borrell’s former doctoral student Ellen Wiewel— now a Director of Research and Evaluation with the NYC Department of Health and the study’s lead author — and Wiewel’s colleague Lucia V. Torian— published their results in the journal AIDS Care.

They turned to the NYC HIV surveillance registry, culling data about suppression rates and the types of facilities patients saw. They found that of the nearly 9,000 individuals newly diagnosed with HIV who achieved suppression between 2006 and 2010, a facility’s size, proximity, and educational resources were all paramount in achieving suppression.

Smaller facilities (like outpatient clinics), those with a smaller number of HIV patients, or those over 10 miles from a patient’s home, tended to negatively impact a patient’s success rate. In fact, patients who visited “small facilities…were 17–28% more likely to experience failure.”

Researchers hope this piece of the puzzle may help with not just the prevention but eventually the elimination of HIV. “Our analysis suggested that assisting people with HIV to attend large health care 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,” Wiewel said in a statement.