The Capacity of HIV Care Facilities to Implement Strategies Recommended by the Ending the HIV Epidemic-The Medical Monitoring Project Facility Survey.

Abstract

Data are needed to assess the capacity of HIV care facilities to implement recommended Ending the HIV Epidemic (EHE) activities. U.S HIV care facilities. We analyzed 2021 survey data from a census of 514 facilities providing care to a national probability sample of U.S. adults with HIV. We present weighted estimates of facility characteristics, services, and policies, and estimates of the proportion of all U.S. HIV patients attending these facilities. Among HIV care facilities, 37% were private practices, 72% were in areas with population > 1 million, and 21% had over 1000 HIV patients. Most provided preexposure prophylaxis (PrEP, 83%) and postexposure prophylaxis (PEP, 84%). Over 67% of facilities provided HIV-specific stigma or discrimination training for all staff (covering 70% of patients) and 66% provided training on cultural competency (covering 74% of patients). A majority of patients attended facilities that provided on-site access to HIV/STI transmission risk reduction counseling (89%); fewer had on-site access to substance use disorders treatment (35%). We found low provision of on-site assistance with food banks or meal delivery (14%) and housing (33%). Approximately 71% of facilities reported using data to systematically monitor patient retention in care. On-site access to adherence tools was available at 58% of facilities; 29% reported notifying patients of missed prescription pickups. Results indicate some strengths that support EHE-recommended strategies among HIV care facilities, such as high availability of PrEP/PEP, as well as areas for improvement, such as provision of staff anti-stigma trainings and adherence supports.