Cargando…

896. Examining the Impact of the COVID-19 Pandemic on Delivery of HIV Care and Prevention Services Among Patients in a Ryan White Clinic

BACKGROUND: We sought to characterize the impact of the COVID-19 pandemic on HIV-related outcomes in a cohort of patients by examining rates of viral load (VL) suppression, retention-in-care, PrEP access, and STIs. METHODS: This was a single center, retrospective study of adults receiving HIV treatm...

Descripción completa

Detalles Bibliográficos
Autores principales: Zhang, Michelle, Butler, Sharlay, Kennedy, Jason, McKune, Molly, Haidar, Ghady, McMahon, Deborah
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8644383/
http://dx.doi.org/10.1093/ofid/ofab466.1091
_version_ 1784610072878383104
author Zhang, Michelle
Butler, Sharlay
Kennedy, Jason
McKune, Molly
Haidar, Ghady
McMahon, Deborah
author_facet Zhang, Michelle
Butler, Sharlay
Kennedy, Jason
McKune, Molly
Haidar, Ghady
McMahon, Deborah
author_sort Zhang, Michelle
collection PubMed
description BACKGROUND: We sought to characterize the impact of the COVID-19 pandemic on HIV-related outcomes in a cohort of patients by examining rates of viral load (VL) suppression, retention-in-care, PrEP access, and STIs. METHODS: This was a single center, retrospective study of adults receiving HIV treatment or HIV/STI prevention services from 01/2019 - 12/2020. HIV outpatient visits were identified through HRSA’s CareWARE. Visits (in-person, telehealth) only included HIV primary care. HRSA core performance measures were utilized (Table 1). STI positivity rates and descriptive characteristics were calculated. New and refill PrEP prescriptions were tabulated. Chi-square tests compared unmatched non-parametric variables; McNemar’s test matched non-parametric variables. Multivariable logistic regression identified variables associated with retention in care and viral suppression. [Image: see text] RESULTS: 1721 patients received care; 1234 were seen in both years, 334 only in 2019, 153 only in 2020. The number of telehealth visits increased significantly: video (0% to 31%, < 0.001), phone (0% to 0.4%, p < 0.001). Though the proportion of kept appointments increased (57.2% vs 61.2%), the annual retention in care rate decreased from 74.5% to 70.9% (p = 0.002). Overall, 9.7% of patients had detectable VLs at any point. Compared to 2019, a lower proportion of patients maintained VL suppression in 2020, (91.6% vs 83.5% p = 0.075). More patients did not have a VL drawn in 2020 than in 2019 (10.3% vs 2.0 %, p < 0.001). Patients with detectable VLs in 2019 were more likely than those who were undetectable to have detectable VLs in 2020 (OR 18.2, 95% CI 9.91-33.42). Black race was associated with higher likelihood of lack of VL suppression (OR = 2.0; 95% CI 1.10-3.66). There were no significant differences between gender or age groups in rates of viral suppression, number screened for bacterial STIs or positive results. Visits for new and refill PrEP prescriptions decreased by 59% and 7%, respectively. CONCLUSION: Rates of viral load suppression and retention in care decreased in 2020 compared to 2019. The proportion of clinic visits attended increased after the integration of telemedicine in 2020. These data may be used to inform evidence-based interventions to improve the HIV continuum of care through telehealth. DISCLOSURES: Ghady Haidar, MD, Karuys (Grant/Research Support)
format Online
Article
Text
id pubmed-8644383
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Oxford University Press
record_format MEDLINE/PubMed
spelling pubmed-86443832021-12-06 896. Examining the Impact of the COVID-19 Pandemic on Delivery of HIV Care and Prevention Services Among Patients in a Ryan White Clinic Zhang, Michelle Butler, Sharlay Kennedy, Jason McKune, Molly Haidar, Ghady McMahon, Deborah Open Forum Infect Dis Poster Abstracts BACKGROUND: We sought to characterize the impact of the COVID-19 pandemic on HIV-related outcomes in a cohort of patients by examining rates of viral load (VL) suppression, retention-in-care, PrEP access, and STIs. METHODS: This was a single center, retrospective study of adults receiving HIV treatment or HIV/STI prevention services from 01/2019 - 12/2020. HIV outpatient visits were identified through HRSA’s CareWARE. Visits (in-person, telehealth) only included HIV primary care. HRSA core performance measures were utilized (Table 1). STI positivity rates and descriptive characteristics were calculated. New and refill PrEP prescriptions were tabulated. Chi-square tests compared unmatched non-parametric variables; McNemar’s test matched non-parametric variables. Multivariable logistic regression identified variables associated with retention in care and viral suppression. [Image: see text] RESULTS: 1721 patients received care; 1234 were seen in both years, 334 only in 2019, 153 only in 2020. The number of telehealth visits increased significantly: video (0% to 31%, < 0.001), phone (0% to 0.4%, p < 0.001). Though the proportion of kept appointments increased (57.2% vs 61.2%), the annual retention in care rate decreased from 74.5% to 70.9% (p = 0.002). Overall, 9.7% of patients had detectable VLs at any point. Compared to 2019, a lower proportion of patients maintained VL suppression in 2020, (91.6% vs 83.5% p = 0.075). More patients did not have a VL drawn in 2020 than in 2019 (10.3% vs 2.0 %, p < 0.001). Patients with detectable VLs in 2019 were more likely than those who were undetectable to have detectable VLs in 2020 (OR 18.2, 95% CI 9.91-33.42). Black race was associated with higher likelihood of lack of VL suppression (OR = 2.0; 95% CI 1.10-3.66). There were no significant differences between gender or age groups in rates of viral suppression, number screened for bacterial STIs or positive results. Visits for new and refill PrEP prescriptions decreased by 59% and 7%, respectively. CONCLUSION: Rates of viral load suppression and retention in care decreased in 2020 compared to 2019. The proportion of clinic visits attended increased after the integration of telemedicine in 2020. These data may be used to inform evidence-based interventions to improve the HIV continuum of care through telehealth. DISCLOSURES: Ghady Haidar, MD, Karuys (Grant/Research Support) Oxford University Press 2021-12-04 /pmc/articles/PMC8644383/ http://dx.doi.org/10.1093/ofid/ofab466.1091 Text en © The Author(s) 2021. Published by Oxford University Press on behalf of Infectious Diseases Society of America. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Poster Abstracts
Zhang, Michelle
Butler, Sharlay
Kennedy, Jason
McKune, Molly
Haidar, Ghady
McMahon, Deborah
896. Examining the Impact of the COVID-19 Pandemic on Delivery of HIV Care and Prevention Services Among Patients in a Ryan White Clinic
title 896. Examining the Impact of the COVID-19 Pandemic on Delivery of HIV Care and Prevention Services Among Patients in a Ryan White Clinic
title_full 896. Examining the Impact of the COVID-19 Pandemic on Delivery of HIV Care and Prevention Services Among Patients in a Ryan White Clinic
title_fullStr 896. Examining the Impact of the COVID-19 Pandemic on Delivery of HIV Care and Prevention Services Among Patients in a Ryan White Clinic
title_full_unstemmed 896. Examining the Impact of the COVID-19 Pandemic on Delivery of HIV Care and Prevention Services Among Patients in a Ryan White Clinic
title_short 896. Examining the Impact of the COVID-19 Pandemic on Delivery of HIV Care and Prevention Services Among Patients in a Ryan White Clinic
title_sort 896. examining the impact of the covid-19 pandemic on delivery of hiv care and prevention services among patients in a ryan white clinic
topic Poster Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8644383/
http://dx.doi.org/10.1093/ofid/ofab466.1091
work_keys_str_mv AT zhangmichelle 896examiningtheimpactofthecovid19pandemicondeliveryofhivcareandpreventionservicesamongpatientsinaryanwhiteclinic
AT butlersharlay 896examiningtheimpactofthecovid19pandemicondeliveryofhivcareandpreventionservicesamongpatientsinaryanwhiteclinic
AT kennedyjason 896examiningtheimpactofthecovid19pandemicondeliveryofhivcareandpreventionservicesamongpatientsinaryanwhiteclinic
AT mckunemolly 896examiningtheimpactofthecovid19pandemicondeliveryofhivcareandpreventionservicesamongpatientsinaryanwhiteclinic
AT haidarghady 896examiningtheimpactofthecovid19pandemicondeliveryofhivcareandpreventionservicesamongpatientsinaryanwhiteclinic
AT mcmahondeborah 896examiningtheimpactofthecovid19pandemicondeliveryofhivcareandpreventionservicesamongpatientsinaryanwhiteclinic