Yelverton Valerie, Ostermann Jan, Yarrington Michael E, Weinhold Andrew K, Natafgi Nabil, Olatosi Bankole, Weissman Sharon, Thielman Nathan M
Department of Medicine, Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina, United States of America.
Department of Health Services Policy and Management, University of South Carolina, Arnold School of Public Health, Columbia, South Carolina, United States of America.
PLoS One. 2025 Jun 4;20(6):e0320911. doi: 10.1371/journal.pone.0320911. eCollection 2025.
To maintain HIV care during the COVID-19 pandemic, many HIV clinics across the United States adopted telehealth. However, not everyone participated in telehealth equally. This study assessed the use and disparities in telehealth and in-person HIV care at a large academic medical center in North Carolina (NC) relative to the COVID-19 pandemic.
Data from the Duke University Infectious Disease clinic in NC were extracted from electronic health records (EHR), aggregated across persons with HIV (PWH) by calendar month, visit type (in-person vs. telehealth HIV care), and by key sociodemographic and clinical characteristics. Variation in HIV care over time was analyzed graphically by age, sex, race and ethnicity, county of residence, and viral load (VL) history.
EHR data from 2,623 PWH receiving care between January 2019 and March 2023 were included. Telehealth use sharply increased in the first months of the pandemic and decreased thereafter. Telehealth use was higher among non-Hispanic Whites compared to People of Color. Most PWH (93%) had a first post-onset-of-the-pandemic (pop) HIV care visit on March 16, 2020 and thereafter. The proportion of telehealth first pop visits peaked in April 2020 with 88% telehealth visits.
Telehealth bridged the initial COVID-19 pandemic phase with drastically reduced in-person visit availability, yet it was not equally utilized across race and ethnicity groups. To guide the optimal integration of telehealth in HIV care and promote equitable care in the future, HIV care outcomes need to be closely monitored, and strategies designed to promote access for Communities of Color are needed.
为在新冠疫情期间维持艾滋病病毒（HIV）护理，美国许多HIV诊所采用了远程医疗。然而，并非每个人参与远程医疗的程度都相同。本研究评估了北卡罗来纳州（NC）一家大型学术医疗中心在新冠疫情期间远程医疗及面对面HIV护理的使用情况和差异。
从北卡罗来纳州杜克大学传染病诊所的电子健康记录（EHR）中提取数据，按日历月、就诊类型（面对面与远程医疗HIV护理）以及关键的社会人口统计学和临床特征，对HIV感染者（PWH）的数据进行汇总。通过年龄、性别、种族和族裔、居住县以及病毒载量（VL）病史，以图形方式分析HIV护理随时间的变化。
纳入了2019年1月至2023年3月期间接受护理的2623名PWH的EHR数据。在疫情的头几个月，远程医疗的使用急剧增加，此后下降。与有色人种相比，非西班牙裔白人的远程医疗使用率更高。大多数PWH（93%）在2020年3月16日及之后进行了疫情爆发后的首次HIV护理就诊。远程医疗首次疫情爆发后就诊的比例在2020年4月达到峰值，其中88%为远程医疗就诊。
远程医疗在新冠疫情初期弥补了面对面就诊机会大幅减少的问题，但不同种族和族裔群体对其利用并不均衡。为指导远程医疗在HIV护理中的最佳整合，并在未来促进公平护理，需要密切监测HIV护理结果，并制定旨在促进有色人种社区获得护理的策略。
