1286. Telehealth Utilization and 2-year Outcomes among People with HIV at a Midwestern Clinic

Abstract

Abstract Background Telehealth platforms such as video and telephone visits serve as mechanisms for HIV care delivery during the COVID-19 pandemic. While telehealth may be instrumental in HIV care, its utilization, sustainability, and impact on patients’ outcomes remain an area for further research. Hence, we compared people with HIV (PWH) utilizing telehealth services to those receiving in-person clinic services at Nebraska's largest HIV clinic in Omaha. Methods HIV Care visits were classified into telehealth and in-person visits. We defined telehealth users as PWH who have utilized telephone or video visits at least once between April 2020 to March 2022. Clinical and demographic comparisons between both groups were made. We conducted bivariate analyses and descriptive statistics for associations and proportions of visit type, viral loads (VL), and completed visits. Results A total of 4,473 visits were completed among 1,308 unique patients (172 telehealth users versus 1136 in-person). Telehealth utilization was significantly higher among patients from cities other than Omaha (< 0.001) and those with income levels above the Federal Poverty Line (FPL) (0.001). Telehealth users made up 73.3% of missed appointments and 50% of canceled visits. Telehealth users were significantly more likely to have undetectable VL than in-person visit users (0.018). In addition, patients who were ≥ 45 years were significantly more likely to have undetectable VL than younger patients (< 0.001). There was no association between gender, race, or year of HIV diagnosis and visit type. Notably, transgender patients (n = 18) did not use telehealth. Overall telehealth utilization dropped from 64% of our total visits in April 2020 to 5% in March 2022. Conclusion In our patient population, telehealth users were more likely to have undetectable VL, live far from the clinic, and have income levels above the FPL than in-person visit users. However, telehealth users were more likely to cancel or miss their medical appointments. Our data also suggest a low preference for telehealth among transgender people. Future studies should develop strategies to improve rates of completed visits among telehealth users, promote telehealth use among transgender men, and sustain the utilization of telehealth beyond the pandemic. Disclosures All Authors: No reported disclosures.