Division of Infectious Disease, Department of Medicine, Vanderbilt University Medical Center, A-2200 MCN, 1161 21st Ave S., Nashville, TN, 37232-2582, USA.
Department of Biostatistics, Vanderbilt University, Nashville, TN, USA.
AIDS Behav. 2022 Aug;26(8):2825-2829. doi: 10.1007/s10461-022-03615-7. Epub 2022 Feb 23.
Access to care is essential for people with HIV (PWH) but may have been affected during the COVID-19 pandemic. We conducted a retrospective cross-sectional study of adult PWH receiving care in a large southeastern comprehensive care clinic in the United States. Patients in care between January 1, 2017, and July 30, 2020, were included. Race/ethnicity, sex, HIV-1 RNA, CD4 + lymphocyte count were included as baseline covariates. Outcomes included clinic attendance, receipt of HIV-1 RNA PCR testing, and virologic suppression (HIV-1 RNA < 200 copies/mL); outpatient encounters included new patient encounters, follow-up visits, and mental health encounters. Total medical encounters, including telemedicine, decreased by 827 visits (33%) when comparing the second quarters of 2019 and 2020. New patient encounters decreased by 23.5% from 81 to 62 during this period. The second quarter of 2020 saw the lowest number of new patient visits since 2017. HIV-1 RNA testing and the proportion of patients with virologic suppression decreased during the pandemic (p < 0.001 for both). Total mental health encounters, on the other hand, increased by 14% during April-June 2020 compared to April-June 2019. Mental health electronic communications increased by 60% from 312 to 500 during the same period, with a 20% increase in medication refills. The COVID-19 pandemic affected outpatient visits, viral load surveillance, and virologic suppression but led to an increase in mental health encounters in a comprehensive care clinic setting.
获得医疗保健对于艾滋病毒感染者（PWH）至关重要，但在 COVID-19 大流行期间可能会受到影响。我们对美国一家大型东南部综合护理诊所接受护理的成年 PWH 进行了回顾性横断面研究。纳入的患者在 2017 年 1 月 1 日至 2020 年 7 月 30 日期间接受护理。将种族/民族、性别、HIV-1 RNA、CD4+淋巴细胞计数作为基线协变量。结局包括诊所就诊、接受 HIV-1 RNA PCR 检测和病毒学抑制（HIV-1 RNA<200 拷贝/ml）；门诊就诊包括新患者就诊、随访就诊和心理健康就诊。与 2019 年第二季度相比，2020 年第二季度总医疗就诊次数（包括远程医疗）减少了 827 次（33%）。在此期间，新患者就诊次数从 81 次减少到 62 次，减少了 23.5%。2020 年第二季度是自 2017 年以来新患者就诊次数最少的一个季度。HIV-1 RNA 检测和病毒学抑制患者比例在大流行期间下降（均<0.001）。另一方面，与 2019 年同期相比，2020 年 4 月至 6 月期间，总心理健康就诊次数增加了 14%。同期，心理健康电子通讯增加了 60%，从 312 次增加到 500 次，药物续方增加了 20%。COVID-19 大流行影响了门诊就诊、病毒载量监测和病毒学抑制，但在综合护理诊所环境中导致心理健康就诊增加。
