Patient Experiences with Telemedicine for HIV Care During the First COVID-19 Wave in Atlanta, Georgia

Galavíz, Karla I.; Shah, N Sarita; Gutierrez, Mariana; Collins, Lauren F; Lahiri, Cecile D.; Moran, Caitlin; Szabo, Brittany; Sumitani, Jeri; Rhodes, J. Stephen; Marconi, Vincent C.; Nguyen, Minh Ly; Cantos, Valeria D; Armstrong, Wendy S.; Colasanti, Jonathan

doi:10.1089/aid.2021.0109

Cited by 16 publications

(16 citation statements)

References 19 publications

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“…Participants described internet connectivity and inadequate quality of care as barriers. Similar to Galaviz and colleagues (2022), our participants were concerned that vital components of their care, such as drawing blood and having viral loads measured, would not be met through telehealth appointments [ 45 ]. Despite such concerns, participants also noted many benefits, such as privacy and reduced transportation barriers [ 25 , 46 , 47 ].…”

Section: Discussionmentioning

confidence: 99%

Socio-Structural Factors and HIV Care Engagement among People Living with HIV during the COVID-19 Pandemic: A Qualitative Study in the United States

et al. 2022

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Achieving HIV prevention goals will require successful engagement in each stage of the HIV continuum. The present study sought to understand the ways in which socio-structural factors influence HIV care engagement among people living with HIV (PLH) within the context of the ongoing COVID-19 pandemic. Twenty-five PLH were recruited from January to October 2021. Semi-structured interviews discussed various socio-contextual factors that influenced engagement in HIV-related care as a result of the pandemic. A thematic content analysis reported semantic level themes describing factors influencing HIV care following an integrated inductive–deductive approach. Qualitative analysis revealed three themes that either supported or hindered engagement in care within the context of the COVID-19 pandemic: (1) social determinants of health, (2) social support, and (3) modes of healthcare delivery. The results underscore the need to assess socio-structural factors of health as means to promote successful engagement in the HIV care continuum and shed new insights to guide future practice in the era of COVID-19.

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Section: Discussionmentioning

confidence: 99%

Socio-Structural Factors and HIV Care Engagement among People Living with HIV during the COVID-19 Pandemic: A Qualitative Study in the United States

et al. 2022

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“…While studies conducted early in the course of the pandemic did not show differences in outcomes of acute COVID-19 associated with HIV status [2][3][4], larger and more carefully designed studies support a growing consensus that people with HIV (PWH) are at higher risk for adverse outcomes [5][6][7][8][9]. In addition, the SARS-CoV-2 pandemic has caused massive disruption to systems of HIV care, potentially affecting access to care and antiretroviral therapy (ART) [10][11][12][13]. Data on SARS-CoV-2-specific adaptive immune responses in PWH compared with HIVnegative individuals remain sparse, with one recent study showing less robust immune responses among PWH [14] but another [15] suggesting similar responses.…”

Section: Introductionmentioning

confidence: 99%

Post-Acute Sequelae and Adaptive Immune Responses in People Living With Hiv Recovering From Sars-Cov-2 Infection

Peluso

Spinelli

Deveau

et al. 2022

Preprint

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Background: Limited data are available on the long-term clinical and immunologic consequences of SARS-CoV-2 infection in people with HIV (PWH). Methods: We measured SARS-CoV-2 specific humoral and cellular immune responses in people with and without HIV recovering from COVID-19 (n=39 and n=43, respectively) using binding antibody, surrogate virus neutralization, intracellular cytokine staining, and inflammatory marker assays. We identified individuals experiencing symptomatic post-acute sequelae of SARS-CoV-2 infection (PASC) and evaluated immunologic parameters. We used linear regression and generalized linear models to examine differences by HIV status in the magnitude of inflammatory and virus-specific antibody and T cell responses, as well as differences in the prevalence of PASC. Results: Among PWH, we found broadly similar SARS-CoV-2-specific antibody and T cell immune responses as compared with a well-matched group of HIV-negative individuals. PWH had 70% lower relative levels of SARS-CoV-2 specific memory CD8+ T cells (p=0.007) and 53% higher relative levels of PD-1+ SARS-CoV-2 specific CD4+ T cells (p=0.007). Higher CD4/CD8 ratio was associated with lower PD-1 expression on SARS-CoV-2 specific CD8+ T cells (0.34-fold effect, p=0.02). HIV status was strongly associated with PASC (odds ratio 4.01, p=0.008), and the proportion of PD-1+ CD4+ T cells and levels of certain inflammatory markers (IL-6, TNF-alpha, and IP-10) were associated with persistent symptoms. Conclusions: We identified potentially important differences in SARS-CoV-2-specific CD4+ and CD8+ T cells that might have implications for long-term immunity conferred by natural infection. HIV status strongly predicted the presence of PASC. Larger and more detailed studies of PASC in PWH are urgently needed.

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“…14,16 However, telemedicine uptake varied across demographic subgroups and a significant portion of patients were limited to using telephone-only encounters. 14,15,17,18,23 Our data on telemedicine visit completion early in the pandemic suggested that younger patients, women, and patients without viral suppression were more likely to complete telemedicine visits compared with in-person visits prepandemic. The type of telemedicine visits used also varied; patients who were older, men, Black, or had recent cocaine or nonprescribed opiate use were more likely to conduct audio-only telemedicine visits rather than use a video-equipped device.…”

Section: Introductionmentioning

confidence: 85%

Telemedicine Use Among People With HIV in 2021: The Hybrid-Care Environment

El-Nahal

Chander

Jones

et al. 2023

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background:Telemedicine use for the care of people with HIV (PWH) significantly expanded during the COVID-19 pandemic. During 2021, vaccine uptake increased and patients were encouraged to resume in-person care, resulting in a mixture of in-person and telemedicine visits. We studied how different patient populations used telemedicine in this hybrid-care environment.Methods:Using observational data from patients enrolled in the Johns Hopkins HIV Clinical Cohort, we analyzed all in-person and telemedicine HIV primary care visits completed in an HIV clinic from January 1st, 2021, to December 31st, 2021. We used log-binomial regression to investigate the association between patient characteristics and the probability of completing a telemedicine versus in-person visit and the probability of completing a video versus telephone visit.Results:A total of 5518 visits were completed by 1884 patients; 4282 (77.6%) visits were in-person, 800 (14.5%) by phone, and 436 (7.9%) by video. The relative risk (RR) of completing telemedicine vs. in-person visits was 0.65 (95% Confidence Interval (CI): 0.47, 0.91) for patients age 65 years or older vs. age 20–39 years; 0.84 (95% CI: 0.72, 0.98) for male patients vs. female patients; 0.81 (95% CI: 0.66, 0.99) for Black vs. White patients; 0.62 (95% CI: 0.49, 0.79) for patients in the highest vs. lowest quartile of Area Deprivation Index; and 1.52 (95% CI: 1.26, 1.84) for patients >15 miles vs. <5 miles from clinic.Conclusions:In the second year of the pandemic, overall in-person care was used more than telemedicine and significant differences persist across subgroups in telemedicine uptake.

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Patient Experiences with Telemedicine for HIV Care During the First COVID-19 Wave in Atlanta, Georgia

Cited by 16 publications

References 19 publications

Socio-Structural Factors and HIV Care Engagement among People Living with HIV during the COVID-19 Pandemic: A Qualitative Study in the United States

Socio-Structural Factors and HIV Care Engagement among People Living with HIV during the COVID-19 Pandemic: A Qualitative Study in the United States

Post-Acute Sequelae and Adaptive Immune Responses in People Living With Hiv Recovering From Sars-Cov-2 Infection

Telemedicine Use Among People With HIV in 2021: The Hybrid-Care Environment

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