1
|
Norwood J, Kheshti A, Shepherd BE, Rebeiro PF, Ahonkhai A, Kelly S, Wanjalla C. The Impact of COVID-19 on the HIV Care Continuum in a Large Urban Southern Clinic. AIDS Behav 2022; 26:2825-2829. [PMID: 35194699 PMCID: PMC8863570 DOI: 10.1007/s10461-022-03615-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2022] [Indexed: 11/18/2022]
Abstract
Access to care is essential for people with HIV (PWH) but may have been affected during the COVID-19 pandemic. We conducted a retrospective cross-sectional study of adult PWH receiving care in a large southeastern comprehensive care clinic in the United States. Patients in care between January 1, 2017, and July 30, 2020, were included. Race/ethnicity, sex, HIV-1 RNA, CD4 + lymphocyte count were included as baseline covariates. Outcomes included clinic attendance, receipt of HIV-1 RNA PCR testing, and virologic suppression (HIV-1 RNA < 200 copies/mL); outpatient encounters included new patient encounters, follow-up visits, and mental health encounters. Total medical encounters, including telemedicine, decreased by 827 visits (33%) when comparing the second quarters of 2019 and 2020. New patient encounters decreased by 23.5% from 81 to 62 during this period. The second quarter of 2020 saw the lowest number of new patient visits since 2017. HIV-1 RNA testing and the proportion of patients with virologic suppression decreased during the pandemic (p < 0.001 for both). Total mental health encounters, on the other hand, increased by 14% during April-June 2020 compared to April-June 2019. Mental health electronic communications increased by 60% from 312 to 500 during the same period, with a 20% increase in medication refills. The COVID-19 pandemic affected outpatient visits, viral load surveillance, and virologic suppression but led to an increase in mental health encounters in a comprehensive care clinic setting.
Collapse
Affiliation(s)
- Jamison Norwood
- Division of Infectious Disease, Department of Medicine, Vanderbilt University Medical Center, A-2200 MCN, 1161 21st Ave S., Nashville, TN, 37232-2582, USA.
| | - Asghar Kheshti
- Division of Infectious Disease, Department of Medicine, Vanderbilt University Medical Center, A-2200 MCN, 1161 21st Ave S., Nashville, TN, 37232-2582, USA
| | - Bryan E Shepherd
- Department of Biostatistics, Vanderbilt University, Nashville, TN, USA
| | - Peter F Rebeiro
- Division of Infectious Disease, Department of Medicine, Vanderbilt University Medical Center, A-2200 MCN, 1161 21st Ave S., Nashville, TN, 37232-2582, USA
- Department of Biostatistics, Vanderbilt University, Nashville, TN, USA
| | - Aimalohi Ahonkhai
- Division of Infectious Disease, Department of Medicine, Vanderbilt University Medical Center, A-2200 MCN, 1161 21st Ave S., Nashville, TN, 37232-2582, USA
| | - Sean Kelly
- Division of Infectious Disease, Department of Medicine, Vanderbilt University Medical Center, A-2200 MCN, 1161 21st Ave S., Nashville, TN, 37232-2582, USA
| | - Celestine Wanjalla
- Division of Infectious Disease, Department of Medicine, Vanderbilt University Medical Center, A-2200 MCN, 1161 21st Ave S., Nashville, TN, 37232-2582, USA.
| |
Collapse
|