The Impact of COVID-19 on the HIV Care Continuum in a Large Urban Southern Clinic.
The Impact of COVID-19 on the HIV Care Continuum in a Large Urban Southern Clinic.
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DOI：
10.1007/s10461-022-03615-7
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发表时间：
2022-08
影响因子：
4.4
通讯作者：
Wanjalla C
中科院分区：
文献类型：
--
作者：
Norwood J;Kheshti A;Shepherd BE;Rebeiro PF;Ahonkhai A;Kelly S;Wanjalla C
获得护理对艾滋病毒感染者（PWH）至关重要，但在COVID-19大流行期间可能受到影响。我们对在美国东南部一家大型综合护理诊所接受护理的成人PWH进行了一项回顾性横断面研究。纳入了2017年1月1日至2020年7月30日期间接受护理的患者。纳入人种/种族、性别、HIV-1 RNA、CD 4+淋巴细胞计数作为基线协变量。结果包括门诊就诊、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、随访和心理健康就诊。与2019年第二季度和2020年第二季度相比，包括远程医疗在内的医疗服务总量减少了827次（33%）。在此期间，新的患者就诊人数从81人下降到62人，下降了23.5%。2020年第二季度的新患者就诊人数是2017年以来的最低水平。在大流行期间，HIV-1 RNA检测和病毒学抑制患者的比例下降（两者均为p < 0.001）。另一方面，与2019年4月至6月相比，2020年4月至6月期间的心理健康接触总数增加了14%。同期，心理健康电子通信从312个增加到500个，增加了60%，药物补充增加了20%。2019冠状病毒病大流行影响了门诊就诊、病毒载量监测和病毒抑制，但导致综合护理诊所环境中的心理健康就诊增加。
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.
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