title: Demand for HIV clinical services is increasing in Australia but supply is decreasing.
abstract: BACKGROUND
  HIV clinical service planning requires accurate estimates of the number of people living with HIV (PLHIV) and the capacity of existing clinical services, each by geographical location. The aim of this study was to quantify current HIV clinical service capacity in Australia.
  
  
  METHODS
  This study was a retrospective analysis of records of HIV clinical service capacity in Australia. Participants were general practitioners who completed an annual survey in 2007-2009. Information on the number of hospital departments, sexual health services, antiretroviral-prescribing general practitioners (ARV-GPs) and shared-care services providing expertise in HIV management from 2007 to 2010 were also available.
  
  
  RESULTS
  From 2007 to 2009, the proportion of ARV-GP survey respondents treating 2-9 patients with HIV per week increased from 36.5% to 49.1%, with a corresponding decrease in the average proportion who saw less than one patient with HIV per week. The estimated number of PLHIV has increased by 12.5% in metropolitan areas, and 16.5% in rural and remote areas over the period 2007-2010; however, the total number of services with at least one HIV ARV-GP has decreased over the same period.
  
  
  CONCLUSIONS
  Current methods to estimate clinical service capacity reveal decreasing supply in the workforce in Australia despite increasing numbers of PLHIV. Further training of HIV clinicians and their placement in regions of greatest supply-demand deficits are required. Further studies are required to precisely quantify and locate the capacity of the HIV clinical workforce with expertise in HIV case-management to enable efficient service planning.
authors.affiliation: The Kirby Institute, University of New South Wales, Sydney, NSW 2010, Australia.
authors.forename: Kylie-Ann
authors.initials: KA
authors.lastname: Mallitt
authors.forename: James
authors.initials: J
authors.lastname: Jansson
authors.forename: Levinia
authors.initials: L
authors.lastname: Crooks
authors.forename: David
authors.initials: D
authors.lastname: McGuigan
authors.forename: Handan
authors.initials: H
authors.lastname: Wand
authors.forename: David P
authors.initials: DP
authors.lastname: Wilson
mesh_terms: D001315:Australia / Q000453:epidemiology; D016009:Chi-Square Distribution; D015658:HIV Infections / Q000453:epidemiology / Q000628:therapy*; D006301:Health Services Needs and Demand; D006801:Humans; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires