Expected drop in HIV care providers may signal potential shift to primary care physicians

Key takeaways:

• More than half of respondents anticipated no increase in volume of HIV care provided in next 5 years.
• Burnout, retirement and documentation time all factored into clinicians’ anticipated decreased HIV care.

A notable proportion of health care providers plan to reduce or stop providing HIV care over the next half decade, even as the need for such care is expected to rise, results from a quantitative national survey showed.

Several factors, such as administrative burden and burnout, affected health care providers’ (HCPs’) attitudes about the likelihood they would reduce or cease care for those living with HIV.

According to Andrea Norberg, DNP, MS, RN, an adjunct assistant professor within the Rutgers School of Nursing, and colleagues, the number of newly diagnosed people with HIV who need antiretroviral therapy is anticipated to increase anywhere between 7% to 36% from 2020 to 2030.

“The need to sustain an adequate health care clinician workforce with expertise in HIV treatment and prevention is essential to the health and well-being of individuals, families, communities, and the entire population,” they wrote in the Journal of the Association of Nurses in AIDS Care.

In the analysis, the researchers surveyed 1,004 physicians, advanced practice nurses, physician assistants and pharmacists who currently provide HIV care to produce a forecast of the HIV care workforce over the next 5 years.

Physicians made up most of the respondents at 60.7%.

Norberg and colleagues found that 33% of respondents expected to maintain the number of people with HIV that they care for in the coming years, whereas 49.2% anticipate increasing the number of patients with HIV in their care.

Meanwhile, 7.3% said they would be caring for fewer people with HIV in the next 5 years, and a further 10.5% of respondents said that they would be stopping HIV care during the same time period.

Factors that contributed to providers stopping or decreasing their HIV care included:

• retirement or reduction of the number of hours in medical practice;
• the time spent on documentation or other administrative work;
• burnout; and
• inadequate support services to help people with HIV.

The researchers noted that younger clinicians — particularly those aged younger than 45 years —Black clinicians, family medicine physicians and nurse practitioners are all likelier to say that they would maintain or increase their HIV care workload.

These findings reflect a “shift” as HIV prevention and treatment “is becoming more and more integrated into primary care practices,” Norberg and colleagues wrote.

The researchers added that Black clinicians being likelier to continue providing HIV care may reflect HIV disparities and prevalence within Black communities across the country.

Providers in certain states and territories, such as New Jersey, New York, Puerto Rico and the U.S. Virgin Islands, also expressed a higher likelihood to maintain or increase HIV care.

The researchers concluded that greater preparation for HIV treatment among primary care providers and other HCPs like nurse practitioners, pediatricians and obstetricians and gynecologists; more funding for HIV training in medical students before licensure; and “continued HIV education and support of clinicians’ postlicensure [a]re needed.”

References:

• Norberg A, et al. J Assoc Nurses AIDS Care. 2024;doi:10.1097/JNC.0000000000000495.
• Survey finds continued declines in HIV clinician workforce. Available at: https://www.eurekalert.org/news-releases/1063647. Published Nov. 4, 2024. Accessed Nov. 5, 2024.