Table 3.
Associations of Provider and Practice Characteristics with Providing Comprehensive Adherence Support.a,b
| Provider Characteristic | Sample size | Weighted row % (CI) | Rao-Scott χ2 P Value | PR (CI) | P Value |
|---|---|---|---|---|---|
| Qualifications and practice experience | |||||
| Certification type | .0004 | ||||
| Nurse practitioner | 138 | 65.9 (57.2–74.6) | 1.93 (1.50–2.48) | <.0001 | |
| Physician assistant | 29 | 48.6 (22.4–74.7) | 1.42 (0.79–2.56) | .28 | |
| ID board-certified MD | 227 | 34.1 (25.1–43.1) | Referent | – | |
| Other board-certified MD | 145 | 41.5 (29.0–54.1) | 1.22 (0.88–1.69) | .25 | |
| Non-board-certified MD | 33 | 45.4 (22.2–68.6) | 1.33 (0.77–2.31) | .34 | |
| HIV-infected patients for whom you provide continuous and direct care | .009 | ||||
| ≤20 | 38 | 29.7 (13.4–46.1) | 0.60 (0.34–1.06) | .05 | |
| 21–50 | 86 | 33.7 (21.0–46.5) | 0.68 (0.45–1.04) | .06 | |
| 51–200 | 222 | 47.2 (38.2–56.2) | 0.96 (0.77–1.20) | .71 | |
| >200 | 217 | 49.2 (40.4–58.0) | Referent | – | |
| Years caring for HIV patients | .001 | ||||
| 0–10 | 230 | 51.8 (40.6–63.0) | 1.67 (1.20–2.33) | .003 | |
| 11–20 | 203 | 42.0 (31.0–53.0) | 1.36 (1.00–1.85) | .06 | |
| >20 | 137 | 30.9 (22.7–39.2) | Referent | – | |
| HIV specialist (HIVMA criteria or AAHIV-S) | .15 | ||||
| No | 151 | 38.0 (25.6–50.5) | Referent | ||
| Yes | 426 | 46.1 (38.8–53.4) | 1.21 (0.90–1.64) | .19 | |
| Provides primary care | <.0001 | ||||
| No | 36 | 26.1 (15.9–36.2) | Referent | – | |
| Yes | 539 | 46.2 (37.8–54.6) | 1.77 (1.25–2.50) | .0003 | |
| Facility characteristics | |||||
| Works at a facility that receives Ryan White funding | .0006 | ||||
| No | 107 | 31.7 (19.4–44.0) | Referent | – | |
| Yes | 418 | 52.9 (46.8–59.1) | 1.67 (1.12–2.48) | .004 | |
| Works in private practice | .003 | ||||
| No | 477 | 50.2 (44.0–56.5) | Referent | ||
| Yes | 100 | 32.6 (19.7–45.6) | 0.65 (0.44–0.95) | .01 | |
| On-site supportive services provided by facility Substance abuse treatment | .007 | ||||
| No | 348 | 38.9 (29.1–48.8) | Referent | – | |
| Yes | 229 | 55.3 (47.0–63.6) | 1.42 (1.04–1.94) | .02 | |
| Mental health services | .05 | ||||
| No | 162 | 36.7 (24.0–49.5) | Referent | – | |
| Yes | 415 | 50.2 (43.6–56.7) | 1.37 (0.95–1.96) | .07 | |
| Case management | .08 | ||||
| No | 139 | 37.1 (25.2–49.0) | Referent | – | |
| Yes | 438 | 48.3 (40.0–56.5) | 1.30 (0.95–1.78) | .08 | |
| Consultations or programs designed to improve ART adherence | .25 | ||||
| No | 115 | 38.4 (24.0–52.7) | Referent | – | |
| Yes | 462 | 46.4 (40.8–52.1) | 1.21 (0.84–1.74) | .27 | |
| Satisfaction with HIV medical practice Satisfied or very satisfied with: | |||||
| Salary and reimbursement | .69 | ||||
| No | 364 | 42.8 (34.7–50.9) | Referent | – | |
| Yes | 212 | 44.6 (33.9–55.2) | 1.04 (0.86–1.26) | .68 | |
| Amount of time required and available for documentation/administrative work | .17 | ||||
| No | 380 | 40.9 (32.6–49.2) | Referent | – | |
| Yes | 193 | 47.6 (35.8–59.3) | 1.16 (0.94–1.44) | .18 | |
| Work schedule/on-call responsibilities | .42 | ||||
| No | 209 | 40.9 (27.6–54.1) | Referent | – | |
| Yes | 365 | 45.6 (38.2–52.9) | 1.12 (0.84–1.48) | .42 | |
| Support services to assist with patient care | .56 | ||||
| No | 252 | 41.3 (29.5–53.1) | Referent | – | |
| Yes | 323 | 44.9 (36.6–53.2) | 1.09 (0.82–1.44) | .56 | |
| Support and coverage from other HIV providers | .79 | ||||
| No | 143 | 44.0 (31.1–56.9) | Referent | – | |
| Yes | 429 | 42.7 (35.0–50.4) | 0.97 (0.77–1.23) | .80 | |
| Availability of specialists for consultation and referral | .66 | ||||
| No | 194 | 44.9 (34.5–55.4) | Referent | – | |
| Yes | 379 | 42.1 (32.0–52.3) | 0.94 (0.70–1.25) | .66 | |
| Effort required to keep up with clinical and/or pharmaceutical advances | .40 | ||||
| No | 217 | 39.9 (26.8–53.1) | Referent | – | |
| Yes | 356 | 45.2 (37.6–52.8) | 1.13 (0.83–1.54) | .41 |
Abbreviations: No., sample size; 95% CI, 95% confidence interval; ART, antiretroviral therapy; MMP, medical monitoring project; PR, prevalence ratio; HIVMA, HIV Medicine Association; AAHIV-S, American Academy of HIV Medicine Practicing HIV Specialist.
a
N = 1187.
b
2013–2014 MMP provider survey.