Outpatient HIV care in the Netherlands

HIV is now, as a result of cART, a treatable condition. Sadly, as reflected by the large number of annual HIV-related deaths and new infections, managing HIV infection and curbing the epidemic has proven extremely challenging. To achieve world without HIV and AIDS, we need to ensure that all infected individuals have timely access to optimal outpatient HIV care. That is to say, outpatient care that facilitates engagement in care over a lifetime, addresses the comorbidities that are increasingly affecting people with HIV, and attends to patients’ overall quality of life. In the present project, the objective was to gain more knowledge on how outpatient HIV care can be improved, in order to attain and maintain the health and well-being of people with HIV. Using the results from these studies, we aim to provide healthcare workers and policy makers with more evidence based recommendations for designing outpatient HIV care.
Our results show that high levels of retention in care and viral suppression are achievable in settings with good access to outpatient HIV care and cART. We recommend applying a minimum volume criterion for HIV treatment centres, regulating measures to ensure that care providers gain and maintain expertise, and regularly measuring performance using uniform, evidence based indicators. There is a need to reassess whether mental health screening and treatment policies are sufficient in HIV treatment centres in the Netherlands. In addition to improving HIV outpatient care, HIV care professionals can play an important part in improving the engagement in earlier phases of the HIV Care continuum.