Assessing the relationship between physician availability and viral load suppression in British Columbia

In 2014, the Joint United Nations Programme on HIV/AIDS set the target of dramatically reducing the burden of HIV through expansion of access to timely HIV treatment. In order to achieve this target, it is necessary to expand access to care along the HIV cascade of care. This study examines the relationship between viral suppression and the availability of physicians providing HIV treatment in British Columbia, Canada. Data from the Drug Treatment Program of the British Columbia Centre for Excellence in HIV/AIDS was analyzed. The floating catchment method was used to assess physician availability and multivariable logistic regression was used to implement a confounder selection technique to independently assess the relationship between physician availability and viral load suppression. Individuals with more than 25 physicians within a one-hour catchment were more likely to reside in urban areas and almost twice as likely to have a suppressed viral load (adjusted odds ratio: 1.97; 95% CI 1.50 – 2.58). This study highlights the impact of physicians’ availability on viral load levels. Mapping technology was used to identify the locations in which patients were most impacted by the lack of physicians.