New VA study shows virtual visits for HIV patients to work

Like other providers, the VA has seen a significant and pandemic increase in virtual tours. In 2019, 27% of visits were virtual compared to 64% in 2020.

The World Health Organization has long advocated for easier access and less time spent in health facilities for people living with HIV, and The Journal of the International AIDS Society created a supplement issue to help understand how the care of people living with HIV changed during the COVID-19 pandemic and whether less time would be detrimental to patients.

One of the studies published in this supplement looked at approximately 28,000 people living with HIV who receive care from the Department of Veterans Affairs, who few realize are the largest providers of HIV care in the world. United States.

Like other providers, the VA has seen a significant and pandemic increase in virtual tours. In 2019, 27% of the visits were virtual compared to 64% in 2020. Interestingly, the vast majority of the virtual visits were carried out by telephone: among the virtual visits, 99% and 92% were by phone (vs video) in 2019 and 2020, respectively.

Among the patients whose viral load was measured, 92% had suppressed levels in 2019 and 91% in 2020. However, the study showed that the proportion of patients who had a viral load measurement increased from 82%. in 2019 to 74% in 2020

“The results showed that the quality of VA HIV health care was maintained during the pandemic,” said Kathleen McGinnis of the US Department of Veterans Affairs, the study’s principal investigator. “VA has dramatically increased the use of virtual visits (mainly by phone) and longer refills (mainly by mail) for antiretroviral therapy drugs. ART (antiretroviral) coverage was maintained and the percentage of VL (viral load) suppression (among those whose VL was measured) was similar during and before the pandemic. “

“With the drastic reduction in in-person services for elective health issues, virtual visits were the best way to keep patients engaged in primary HIV care,” observes McGinnis.

Prescribing policy adjustments in 2020 have allowed more people to get prescriptions for a 90-day supply of antiretroviral drugs that suppress HIV and keep infected people healthy. In 2020, just over half (51%) of renewals of 90 days or more, compared to 39% in 2019. Although there were a lower number of renewals in 2020 compared to 2019, because the duration Prescription average was longer, coverage was similar for 2019 and 2020, ranging from 76% to 80% for all months except March 2019, which was at 72%.

McGinnis and colleagues used data from the Veterans Aging Cohort Study to conduct their research

It is widely believed that virtual tours will continue to be more common than they were before the pandemic, both in general and especially among those with mobility and / or transportation challenges.

“The results could have long-term implications for more effective HIV care in general, possibly involving longer dispensing prescriptions, greater use of mail in prescription services, fewer in-person visits. and less frequent CV testing, ”says McGinnis.

Nonetheless, she notes that more research is needed to determine if there are other, as yet unmeasured, side effects, such as decreased prescription drug adherence for other conditions.

About Bradley J. Bridges

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