Emerging from the shadows: Trends in HIV ambulatory care, viral load testing, and viral suppression in a U.S. HIV cohort, 2019-2022: Impact of COVID-19 pandemic.

Autor:	Tedaldi E; Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA., Hou Q; Cerner Corporation, Kansas City, MO, USA., Armon C; Cerner Corporation, Kansas City, MO, USA., Mahnken JD; Cerner Corporation, Kansas City, MO, USA., Palella F FJ; Northwestern University Feinberg School of Medicine, Chicago, IL, USA., Simoncini G; AIDS Healthcare Foundation, Philadelphia, PA, USA., Fuhrer J; Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA., Mayer C; St. Joseph's Comprehensive Research Institute, Tampa, FL, USA.; Department of Medicine, Anschutz Medical Center, Aurora, CO, USA., Ewing A; Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA., Chagaris K; Cerner Corporation, Kansas City, MO, USA., Carlson KJ; Cerner Corporation, Kansas City, MO, USA., Li J; Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA., Buchacz K; Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Jazyk:	angličtina
Zdroj:	Journal of investigative medicine : the official publication of the American Federation for Clinical Research [J Investig Med] 2024 Oct; Vol. 72 (7), pp. 661-673. Date of Electronic Publication: 2024 May 27.
DOI:	10.1177/10815589241252592
Abstrakt:	This article aimed at analyzing the acute impact and the longer-term recovery of COVID-19 pandemic effects on clinical encounter types, HIV viral load (VL) testing, and suppression (HIV VL < 200 copies/mL). This study was a longitudinal cohort study of participants seen during 2019-2022 at nine HIV Outpatient Study (HOPS) sites. Generalized linear mixed models (GLMMs) estimated monthly rates of all encounters, office and telemedicine visits, and HIV VL tests using 2010-2022 data. We examined factors associated with nonsuppressed VL (VL ≥ 200 copies/mL) and not having ambulatory care visits during the pandemic using GLMM for logistic regression with 2017-2022 and 2019-2022 data, respectively. Of 2351 active participants, 76.0% were male, 57.6% aged ≥ 50 years, 40.7% non-Hispanic White, 38.2% non-Hispanic Black, 17.3% Hispanic/Latino, and 51.0% publicly insured. The monthly rates of in-person and telemedicine visits varied during 2020 through mid-year 2022. Multivariable logistic regression showed that persons with no encounters were more likely to be male or have VL ≥ 200 copies/mL. For participants with ≥1 VL test, the prevalence rate of HIV VL ≥ 200 copies/mL during 2020 was close to the rates from 2014 to 2019. The change in probability of viral suppression was not associated with participant's age, sex, race/ethnicity, or insurance type. In the HOPS, overall patient encounters declined over 2 years during the pandemic with variations in telemedicine and in-person events, with relative maintenance of viral suppression. Ongoing recovery from the impact of COVID-19 on ambulatory care will require continued efforts to improve retention and patient access to medical services. Competing Interests: Declaration of conflicting interestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Frank J Palella has been a consultant and /or on the Speakers’ Bureau for Gilead Sciences, Janssen Pharmaceuticals, Merck and Co. and ViiV. The other co-authors declare no conflicts of interest.
Databáze:	MEDLINE
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