Author/ Publication year

Country

Study Design

Study population/ setting

Intervention

Outcomes

Notes

Chu 2010 (14)

New York, USA

Retrospective cohort study. Data collected for years 2005-2008

Non-pregnant HIV positive adults 18+ years on cART in community-based primary care network (CB) (n = 178) vs. a large tertiary care center and teaching hospital (HB) (n = 237)

CB: non-HIV-expert PCP in collaboration with accredited HIV specialists (all general internal/family medicine-trained) vs. HB: ID-trained clinicians

CB

HB

Fewer patients initiating cART than needed for statistical significance. Data were adjusted for patients’ characteristics.

VL

adj OR 1.22, 95% CI 0.41 to 3.63.

CD4 count

adj OR 0.76, 95% CI 0.47 to 1.21

Gardner 2002 (21)

USA

Cross-sectional analysis. Data collected for years 1998-1999

HIV-infected women (n = 273)

HIV-specialist care vs. non-HIV-specialist care.

HIV-specialist

Non-HIV-specialist

Self-reported use of ART. Analysis for use of ART was adjusted for significant predictors that led women to use HIV-specialist care. Provider type based on self-report by patients. Data on types of ART use were adjusted for patients’ characteristics. All other data, no adjustment was stated.

ART use

- -CD4 cell count < 200 (P = 0.6)

- -CD4 cell count 200 - 500 (P ≤ 0.001)

- -CD4 cell count > 500 (P = 0.45)

- -All CD4 cell count groups (P < 0.001)

PJP

- -CD4 cell count < 100/mm³ (P = 0.19)

Horberg 2012 (15)

California, USA

Retrospective cohort analysis. Data collected for years 1996-2006

HIV-infected patients initiating a new cART regimen (n = 7.071) or initiating a second or later cART (n = 3730) in an integrated healthcare system

Non-ID/non-HIV-expert PCP vs. non-ID but HIV-expert PCP vs. ID specialists vs. HIV-trained NP/PA

Non-ID/ non-HIV expert

Non-ID, HIV expert

ID specialist

NP/ PA

All data were adjusted for clustering effect and patients’ characteristics. Clinicians with more HIV caseload (adj P = 0.03) and experience (adj P = 0.003) was significant in VL success after 12 months of cART initiation among ART-naïve patients but not ART-experienced patients (caseload: adj P = 0.96; experience: adj P = 0.98).

VL

Undetectable at 12 months in:

- -ART-naïve patients (adj P = 0.36)

- -ART-experienced patients (adj P = 0.80)

ART adherence

- -ART-naïve patients (adj P = 0.97)

- -ART-experienced patients (adj P = 0.66)

Landon 2003 (16)

USA

Prospective cohort study. Data collected for years 1998-1999

Non-institutionalized HIV patients participating in a research study (n = 1820).

ID-trained physicians vs. GM HIV-expert physicians vs. GM non-HIV-expert physicians

ID physician

GM HIV-expert

GM non-HIV expert

All data were adjusted for patients’ characteristics.

Appropriate cART therapy at 12 & 18 months after first protease inhibitor approval

- -GM (HIV-expert and non-HIV-expert) vs. ID physicians: adj OR 0.69, 95% CI 0.52 to 0.95

- -non-HIV-expert GM vs. ID physicians: adj OR 0.32, 95% CI 0.17 to 0.61

- -HIV-expert GM vs. ID physicians: adj OR 0.80, 95% CI 0.59 to 1.10.

- -Low-volume physicians vs. high-volume physicians OR 0.26, 95% CI 0.14 to 0.48