Department of Infectious Diseases, Children's National Hospital, Washington, DC.
Department of Pediatrics, School of Medicine and Health Sciences, George Washington University, Washington, DC.
J Acquir Immune Defic Syndr. 2021 Dec 1;88(4):384-388. doi: 10.1097/QAI.0000000000002792.
BACKGROUND: In response to the COVID-19 pandemic, we scaled up telemedicine and rideshare services for clinic and laboratory visits for pediatric and adolescent patients with HIV. SETTING: HIV subspecialty program for patients aged 0-24 years at Children's National Hospital, Washington, DC. METHODS: Using the χ2 and Wilcoxon rank sum tests, we compared demographics, visit and laboratory data, and rideshare usage among patients who scheduled telemedicine at least once (telemedicine) versus those who never scheduled telemedicine (no-telemedicine) during the pandemic (April-September 2020). We compared the number and proportion of scheduled and completed clinic visits before the pandemic (April-September 2019) with those during the pandemic. RESULTS: We analyzed 178 pediatric and adolescent patients with HIV (median age 17.9 years, 89.3% Black, 48.9% male patients, 78.7% perinatally infected), of whom 70.2% and 28.6% used telemedicine and rideshare, respectively. Telemedicine patients scheduled more visits (236 vs 179, P < 0.0001) and completed a similar proportion of visits (81.8% vs 86.0%, P = 0.3805) compared with no-telemedicine patients. Laboratory testing rates (81.3% versus 98.5%, P = 0.0005) were lower in telemedicine patients compared with no-telemedicine patients. Rideshare usage (12.4% versus 26.5%, P = 0.0068) was lower in telemedicine versus no-telemedicine patients. During the pandemic, most of the patients (81.0%) had HIV RNA <200 copies/mL. The total number of completed visits and the proportion of visits completed were similar before and during the pandemic. CONCLUSION: Most of the pediatric and adolescent patients with HIV used telemedicine and maintained HIV RNA <200 copies/mL during the pandemic. Despite rideshare usage, laboratory testing rates were lower with telemedicine compared with in-person visits.
背景：为应对 COVID-19 大流行，我们扩大了远程医疗和拼车服务，以方便儿科和青少年艾滋病毒感染者进行门诊和实验室就诊。
地点：华盛顿特区儿童国家医院的儿科艾滋病专科。
方法：使用 χ2 和 Wilcoxon 秩和检验，我们比较了在大流行期间（2020 年 4 月至 9 月）至少预约过一次远程医疗（远程医疗）和从未预约过远程医疗（无远程医疗）的患者的人口统计学特征、就诊和实验室数据以及拼车使用情况。我们比较了大流行前（2019 年 4 月至 9 月）和大流行期间计划和完成的门诊就诊次数和比例。
结果：我们分析了 178 例儿科和青少年艾滋病毒感染者（中位年龄 17.9 岁，89.3%为黑人，48.9%为男性患者，78.7%为围产期感染），其中 70.2%和 28.6%分别使用了远程医疗和拼车。与无远程医疗患者相比，远程医疗患者预约的就诊次数更多（236 次与 179 次，P<0.0001），完成就诊的比例相似（81.8%与 86.0%，P=0.3805）。与无远程医疗患者相比，远程医疗患者的实验室检测率（81.3%与 98.5%，P=0.0005）较低。与无远程医疗患者相比，远程医疗患者的拼车使用率（12.4%与 26.5%，P=0.0068）较低。在大流行期间，大多数患者（81.0%）的 HIV RNA<200 拷贝/mL。大流行前后完成的就诊次数总数和就诊完成比例相似。
结论：大多数儿科和青少年艾滋病毒感染者在大流行期间使用了远程医疗，并保持 HIV RNA<200 拷贝/mL。尽管使用了拼车服务，但与面对面就诊相比，远程医疗的实验室检测率较低。
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