Does quality of care differ when HIV patients are treated by non-specialist and specialist HIV healthcare providers in developed countries? A Systematic narrative review

Bossakara Sokhom, Emmanuel Okpo (Corresponding Author), Ivan Tonna, Amudha Poobalan

Research output: Contribution to journalArticlepeer-review

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Abstract

Introduction: In developed countries, HIV care is mostly provided by trained specialist healthcare professionals. Due to the increasing demand for HIV care, pressure on healthcare providers to reduce cost and the current global economic constraints, many developed countries are searching for alternative HIV care models. This review aims to consider whether HIV treatment and care can be provided as effectively and safely by doctors and nurses with no HIV-specialist training compared to those with HIV-specialist training.
Methods: Three electronic bibliographic databases MEDLINE, EMBASE and the Cochrane Library were searched for studies conducted between January 1996 and March 2015. Manual searches of reference lists of all relevant reports retrieved from the electronic databases were conducted. All comparative studies examining the quality of HIV care provided by different types of healthcare providers in developed countries were included.
Results: Nine observational studies involving 27,015 patients were included in the review. Eight studies were conducted in the USA and one study in Switzerland. Healthcare providers with HIV related expertise and or training and those without HIV-related expertise or training who collaborated with providers with HIV-related expertise and or training outperformed other healthcare providers in many virological, immunological and ART-related outcomes.
Conclusion: This review found moderate quality evidence that HIV care can be provided effectively by non-HIV specialists if they have access to HIV specialists or experts for advice and support.
Original languageEnglish
Pages (from-to)161-174
Number of pages14
JournalWorld Journal of AIDS
Volume5
Issue number3
DOIs
Publication statusPublished - 28 Aug 2015

Keywords

  • HIV/AIDS
  • health care providers
  • quality of care
  • systematic review
  • developed countries

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