Telemedicine and HIV Care Quality Measures during the COVID-19 Pandemic

Mary Clare Masters*, Juan Rivera, Mia Calamari, Katherine Wright, Patrick Janulis, Laura Rusie, Jacqueline Bannon, Patrick Milne, Shannon R. Galvin, Elena Gonzalez Molina, Lisa R. Hirschhorn, Frank J. Palella, Rebecca Kumar, Cory Brown, Claudia Hawkins

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background:During the COVID-19 pandemic, telemedicine was adopted to ensure continuity of HIV care. We examined how introducing televisits affected technical quality of care for people with HIV (PWH) during this time.Methods:PWH receiving HIV care at Howard Brown Health Centers and Northwestern University in Chicago, Illinois were included. HIV care quality indicators were calculated using data extracted from electronic medical records during 4 timepoints every 6 months from March, March 1, 2020 to September 1, 2021. Generalized linear mixed models estimated differences in indicators across timepoints within each site while controlling for multiple observations of individuals. Generalized linear mixed models were also used to compare differences in outcomes among PWH who attended all versus a combination of in-person and televisits versus no televisits across the study time periods.Results:6447 PWH were included in the analysis. Compared with prepandemic levels, there were significant declines in care utilization and processes of care measures. Measures of HIV virologic suppression, blood pressure control, and HbA1C <7% (in both people with and without diabetes) were stable with no significant differences noted across the study timepoints. Similar trends were observed across all age, race, and sex subgroups. In multivariable models, televisits were not associated with decreased HIV viral suppression.Conclusions:During the COVID-19 pandemic and rapid implementation of televisits, indicators of care utilization and processes of care decreased compared with prepandemic levels. Among PWH who remained in care, televisits were not associated with worse virologic, blood pressure, and glycemic control in PWH.

Original languageEnglish (US)
Pages (from-to)46-52
Number of pages7
JournalJournal of Acquired Immune Deficiency Syndromes
Volume94
Issue number1
DOIs
StatePublished - Sep 1 2023

Keywords

  • COVID-19
  • HIV
  • care continuum
  • telemedicine

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

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