ABSTRACT
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.
Subject(s)
COVID-19 , HIV Infections , Adult , COVID-19/epidemiology , Continuity of Patient Care , Cross-Sectional Studies , HIV Infections/drug therapy , HIV Infections/epidemiology , Humans , Pandemics , RNA/therapeutic use , Retrospective Studies , United States , Viral LoadABSTRACT
In ecologic analyses of US states, piecewise multivariable models showed lower case-rate slopes after implementation of mask requirements: -1.0% (95% confidence interval, -1.34% to -.57%) and -0.44% (-.86% to -.03%) per 100â 000 per day in early- and late-adopter states, respectively, compared with never-adopter states. Our findings support statewide mask requirements to mitigate transmission of coronavirus disease 2019.