Rehman Nadia, Mbuagbaw Lawrence, Mertz Dominik, Muraca Giulia M, Jones Aaron
Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada.
PLoS One. 2025 May 28;20(5):e0315880. doi: 10.1371/journal.pone.0315880. eCollection 2025.
Virtual care has been integrated as a modality of care in Ontario, yet its effectiveness for people living with HIV remains largely unexplored.
We aimed to determine the association of visit modality (virtual, in-person, or both) on adherence to antiretroviral therapy (ART), viral load, and quality of life (QoL) in people living with HIV in Ontario, Canada.
We conducted a cross-sectional study using data from the 2022 Ontario HIV Treatment Network Cohort Study (OCS), collected during the COVID-19 pandemic when virtual visits were first introduced. Participants were grouped into three categories based on the mode of care: virtual, in-person, or a combination of both. Data were collected through self-reported questionnaires and medical records, with viral load data linked to Public Health Ontario Laboratories (PHOL). Logistic regression was used to examine the outcomes of optimal ART adherence and viral load suppression, and linear regression was used for quality of life (mental and physical) outcomes.
In 2022, 1930 participants accessed HIV care in the OCS. Among them, 19.0% received virtual care, 45.6% received in-person care, and 34.3% received care through virtual and in-person modalities. The median age of the participants was 55 years (IQR: 45-62). In the multivariable logistic regression model, virtual care was associated with an increased likelihood of optimal adherence to antiretroviral therapy (Adjusted Odds Ratio (AOR) 1.30, 95% confidence interval (CI): 1.00, 1.70) and an increased likelihood of achieving viral load suppression (AOR 1.67, 95% CI:1.03, 2.63). Moreover, combined virtual and in-person care is associated with an improved mental quality of life compared to in-person care (Adjusted Mean difference (MD) - 0.960, 95% CI: 0.05, 1.87).
This study suggests virtual care is positively associated with adherence to antiretroviral therapy (ART) and viral suppression within this context. However, future research is necessary to establish causality and to assess the long-term effects of virtual care.
虚拟医疗已成为安大略省的一种医疗模式，但其对艾滋病毒感染者的有效性在很大程度上仍未得到探索。
我们旨在确定就诊模式（虚拟、面对面或两者兼有）与加拿大安大略省艾滋病毒感染者的抗逆转录病毒疗法（ART）依从性、病毒载量和生活质量（QoL）之间的关联。
我们使用2022年安大略省艾滋病毒治疗网络队列研究（OCS）的数据进行了一项横断面研究，这些数据是在首次引入虚拟就诊的新冠疫情期间收集的。参与者根据护理模式分为三类：虚拟、面对面或两者结合。数据通过自我报告问卷和医疗记录收集，病毒载量数据与安大略省公共卫生实验室（PHOL）相关联。逻辑回归用于检查最佳ART依从性和病毒载量抑制的结果，线性回归用于生活质量（心理和身体）结果。
2022年，1930名参与者在OCS接受了艾滋病毒护理。其中，19.0%接受虚拟护理，45.6%接受面对面护理，34.3%通过虚拟和面对面模式接受护理。参与者的中位年龄为55岁（IQR：45 - 62）。在多变量逻辑回归模型中，虚拟护理与最佳抗逆转录病毒疗法依从性增加的可能性相关（调整优势比（AOR）1.30，95%置信区间（CI）：1.00，1.70）以及实现病毒载量抑制增加的可能性相关（AOR 1.67，95% CI：1.03，2.63）。此外，与面对面护理相比，虚拟和面对面结合的护理与改善的心理生活质量相关（调整平均差（MD） - 0.960，95% CI：0.05，1.87）。
本研究表明，在此背景下，虚拟护理与抗逆转录病毒疗法（ART）的依从性和病毒抑制呈正相关。然而，有必要进行进一步研究以确定因果关系并评估虚拟护理的长期影响。
