Impact of Telehealth in HIV Ambulatory Clinic during COVID-19 Pandemic

Abstract

BackgroundThe COVID-19 pandemic has changed HIV outpatient care. Patients (pts) were transitioned from in-person (IN-P) visits to telehealth (TELE) encounters. We sought to evaluate the impact of TELE on HIV infected pts during the pandemic period (COV) and compare it to the pre-pandemic (pre-COV) care.MethodsA retrospective study in an outpatient HIV clinic. Two periods were defined: Pre-COV 3/16/2019 - 3/15/2020 and COV 3/16/2020- 3/15/2021. Data was collected on demographics, lab values and physician encounters. ResultsA total of 1136 pts were seen over 2 years, mean age 51.6 years. During pre-COV, 530 pts were seen IN-P and 606 pts had encounters during COV, of them 50.2% had exclusive TELE visits. The percentage of pts with CD4 > 200/µL and those with undetectable HIV VL at first and last encounter were compared between the two study periods. During pre-COV, there was no difference in the percent pts with CD4 > 200/µL (B90.5% vs. 94.3%, p=.87) or HIV VL (88.5% vs. 90.3%, p=0.41) but during COV there was significant difference in CD4 (90.3% vs. 94.2%, p=0.03) and HIV VL (87% vs. 93%, p=0.002). More new pts were seen and less changes to ART regimens were done during COV (8.6%vs 7 p=0.26) and (19% to 29%, p=0 .32) respectively.ConclusionsIn our clinic, transitioning to TELE resulted in larger number of encounters and more new pts entered care; CD4 and HIV viral load improvements were seen. TELE is an effective platform for HIV out patient care.