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. 2018 Jun 20;13(6):e0199395.
doi: 10.1371/journal.pone.0199395. eCollection 2018.

The organizational attributes of HIV care delivery models in Canada: A cross-sectional study

Claire E Kendall  1   2   3   4   5 , Esther Susanna Shoemaker  1   2   3   5 , Lisa Boucher  1   2 , Danielle E Rolfe  2 , Lois Crowe  1 , Marissa Becker  6 , Shabnam Asghari  7 , Sean B Rourke  4   8 , Ron Rosenes  1 , Christine Bibeau  1 , Philip Lundrigan  1 , Clare Liddy  1   2
Affiliations

The organizational attributes of HIV care delivery models in Canada: A cross-sectional study

Claire E Kendall et al. PLoS One. .

Abstract

HIV treatment in Canada has rapidly progressed with the advent of new drug therapies and approaches to care. With this evolution, there is increasing interest in Canada in understanding the current delivery of HIV care, specifically where care is delivered, how, and by whom, to inform the design of care models required to meet the evolving needs of the population. We conducted a cross-sectional survey of Canadian care settings identified as delivering HIV care between June 2015 and January 2016. Given known potential differences in delivery approaches, we stratified settings as primary care or specialist settings, and described their structure, geographic location, populations served, health human resources, technological resources, and available clinical services. We received responses from 22 of 43 contacted care settings located in seven Canadian provinces (51.2% response rate). The total number of patients and HIV patients served by the participating settings was 38,060 and 17,678, respectively (mean number of HIV patients in primary care settings = 1,005, mean number of HIV patients in specialist care settings = 562). Settings were urban for 20 of the 22 (90.9%) clinics and 14 (63.6%) were entirely HIV focused. Primary care settings were more likely to offer preventative services (e.g., cervical smear, needle exchange, IUD insertion, chronic disease self-management program) than specialist settings. The study illustrates diversity in Canadian HIV care settings. All settings were team based, but primary care settings offered a broader range of preventative services and comprehensive access to mental health services, including addictions and peer support.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Location and number of invited and participating HIV care settings (# invited: # completed).
Fig 2
Fig 2. Staffing of primary and specialist care HIV settings.
TB = tuberculosis; STI = sexually transmitted diseases; F/U = follow up; IUD = intra uterine device; CDSM = chronic disease self-management; MSK = musculoskeletal.
Fig 3
Fig 3. Clinical services available in primary and specialist HIV care settings.
See this image and copyright information in PMC

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