Did telehealth appointments improve retention of HIV care during the COVID-19 pandemic?

In a recent study published in AIDS and behavior, Researchers evaluated how the coronavirus disease 2019 (COVID-19) pandemic changed measures of retention in human immunodeficiency virus (HIV) care.

Background

The outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in one of the most serious public health crises in recent years. The COVID-19 pandemic has changed the way people interact around the world due to the need for social distancing to limit the spread of the virus.

Studies investigating the impact of COVID-19 on other healthcare measures as the severe COVID-19 threat is now under control thanks to various vaccinations and antiviral therapies developed in the last two years is now started.

Acquired immunodeficiency syndrome (AIDS) care requires retention to ensure the health of individuals with HIV and to prevent transmission of HIV in the community.

Maintenance rates, such as viral load and CD4+ cell count monitoring, and maintenance of antiretroviral therapy, are commonly performed in HIV care clinics and measured by the interval between consecutive visits to an HIV care clinic or the number of missed visits per year.

During the COVID-19 pandemic, HIV care clinics in the United States (US) must cancel in-person retention visits and incorporate telemedicine appointments to provide continued care for people living with HIV (PWH). had. However, the impact of these changes on HIV retention measures has not yet been investigated.

About research

This study evaluated retention measures during the first year of the COVID-19 pandemic and in the years prior to the pandemic at a medical clinic in Chicago, Illinois, and how the inclusion of telemedicine appointments affected these measures. I investigated whether

Researchers collected data on PWHs aged 18 years and older who received HIV care at an HIV care clinic between 15 March 2018 and 14 March 2021. The HIV Care Clinic has canceled in-person appointments starting March 15, 2020.

Therefore, the study period was the pre-pandemic phase from 15 March 2019 to 14 March 2020, and 15 March 2020 and 14 March 2021, which were considered the first years of the pandemic period. Divided. Participant inclusion is based on at least one appointment between March 15, 2018 and March 15, 2020.

Data were collected from participants on demographic factors, comorbidities, in-person and telemedicine HIV care appointments, and outcomes of these appointments. Six HIV care retention measures were calculated. These included 3 absent-visit measures and 3 continuous-visit measures. These measures were calculated separately for the pre-pandemic and pandemic periods and were further split based on whether telemedicine appointments were included or excluded.

result

Results showed that patient retention rates declined during the COVID-19 pandemic, but the demographic characteristics of maintained patients remained similar over both study periods. Maintained visit retention rates indicated that PWH was more likely to be maintained in the pre-pandemic phase than during the COVID-19 pandemic.

The Health Resources Administration HIV/AIDS Service (HRSA HAB) measure consisted of two consecutive visits separated by at least 90 days during the 1-year observation period and was associated with pre-pandemic maintenance rates. 72%, retention during pandemic.

The authors noted that other studies found missed HIV care visits related to concerns about food security, housing, mental health, and substance use during the pandemic.

Notably, PWH considered retained during the pandemic increased according to all three continuous visit measures when telemedicine appointments were included in the analysis. This indicates that telemedicine facilities have improved access to HIV care during the COVID-19 pandemic.

Telemedicine appointments are limited by the inability to take vitals or perform laboratory tests, but PWH reports improved ability to discuss treatment and prescription refill needs with providers doing.

Interestingly, the Spearman coefficients calculated in this study show that visit measures retained during the pandemic relative to the pre-pandemic period with and without telehealth appointments included It shows a higher correlation between values. The authors believe this provided reassurance that traditional retention measures remained effective during the COVID-19 pandemic.

Conclusion

In summary, this study examined the impact of the COVID-19 pandemic and the introduction of telemedicine appointments in HIV health care facilities in the United States on PWH maintenance of HIV care. Results showed a decrease in retention with the onset of the pandemic. This is partially explained by the cancellation of face-to-face appointments by care clinics.

Including telemedicine appointments resulted in more retention. Despite the limitations of testing telemedicine methods, the participant reported being able to communicate with her HIV care provider during the pandemic was helpful.

Findings highlight the need to include telemedicine in HIV care retention strategies.