Identifying Health Care Services Offered in the HIV Care Continuum via Machine Learning-Based Topic Modeling Approach: Exploratory Literature Review

Abstract

Background: It remains unclear whether the existing health care services reflect the HIV care continuum, which underscores the need for integrated care beyond viral suppression.

Objective: This study aimed to analyze the literature on health care services for people living with HIV to enhance the understanding of trends and knowledge structures.

Methods: A literature review was conducted using BERTopic, an advanced machine learning-based topic modeling technique. We searched PubMed, CINAHL, EMBASE, and Cochrane databases for English-language studies published between 2013 and 2023. Analyses were performed twice: first, to gain a broad understanding of the literature, and second, to examine the specific details of health care services described.

Results: Among the 11,269 articles screened, 204 studies met the inclusion criteria. Within the HIV care continuum, most studies focused on the treatment retention stage, while studies focusing on the long-term stage were limited. A broad literature analysis identified five key topics, with "ART adherence" emerging as the most prominent topic. A more comprehensive analysis of health care services within the literature revealed 7 topics, reflecting diverse delivery methods and content in providing health care services for people living with HIV. The predominant topic, "ART adherence and counseling," encompassed the largest number of studies, indicating the strongest emphasis in the field. Notably, the distribution of topics exhibited a distinct pattern: while health care service diversity was the highest in the earlier stages of the HIV care continuum, it became increasingly limited in the later stages.

Conclusions: This study provides valuable insights into current HIV care services and highlights areas for future research and intervention. Despite the shift toward lifelong HIV management, existing literature remains heavily focused on medication treatment, overlooking the multifaceted health care needs of people living with HIV. Research disparities, particularly concerning vulnerable populations, underscore the need for more inclusive studies and tailored health care services. Efforts should be intensified to bridge these gaps, ensuring inclusive and equitable health care services across diverse populations and fostering interdisciplinary collaboration to meet the evolving needs of people living with HIV, thereby enhancing the HIV care continuum for all.