Telemedicine and HIV care quality measures during the COVID-19 pandemic.

Abstract

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. 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 3/1/2020 to 9/1/2021. 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. 6,447 PWH were included in the analysis. Compared to pre-pandemic levels, there were significant declines in care utilization and processes of care measures. Measures of HIV virologic suppression, blood pressure (BP) 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. During the COVID-19 pandemic and rapid implementation of televisits, indicators of care utilization and processes of care decreased compared to pre-pandemic levels. Among PWH who remained in care, televisits were not associated with worse virologic, BP, and glycemic control in PWH.