Abstract:
This article aimed at analyzing the acute impact and the longer-term recovery of COVID-19 pandemic effects on clinical encounter types, HIV viral load (VL) testing, and suppression (HIV VL < 200 copies/mL). This study was a longitudinal cohort study of participants seen during 2019-2022 at nine HIV Outpatient Study (HOPS) sites. Generalized linear mixed models (GLMMs) estimated monthly rates of all encounters, office and telemedicine visits, and HIV VL tests using 2010-2022 data. We examined factors associated with nonsuppressed VL (VL ≥ 200 copies/mL) and not having ambulatory care visits during the pandemic using GLMM for logistic regression with 2017-2022 and 2019-2022 data, respectively. Of 2351 active participants, 76.0% were male, 57.6% aged ≥ 50 years, 40.7% non-Hispanic White, 38.2% non-Hispanic Black, 17.3% Hispanic/Latino, and 51.0% publicly insured. The monthly rates of in-person and telemedicine visits varied during 2020 through mid-year 2022. Multivariable logistic regression showed that persons with no encounters were more likely to be male or have VL ≥ 200 copies/mL. For participants with ≥1 VL test, the prevalence rate of HIV VL ≥ 200 copies/mL during 2020 was close to the rates from 2014 to 2019. The change in probability of viral suppression was not associated with participant\'s age, sex, race/ethnicity, or insurance type. In the HOPS, overall patient encounters declined over 2 years during the pandemic with variations in telemedicine and in-person events, with relative maintenance of viral suppression. Ongoing recovery from the impact of COVID-19 on ambulatory care will require continued efforts to improve retention and patient access to medical services.
摘要:
目的:分析COVID-19大流行效应对临床接触类型的急性影响和长期恢复,HIV病毒载量(VL)测试和抑制(HIVVL<200拷贝/mL)。
■2019-2022年期间在八个HIV门诊研究(HOPS)站点进行的参与者的纵向队列研究。
■广义线性混合模型(GLMM)估计所有相遇的月费率,办公室和远程医疗访问,和HIVVL检测使用2010-2022年数据。我们使用GLMM对2017-2022年和2019-2022年数据进行逻辑回归,研究了与非抑制VL(VL≥200拷贝/mL)和大流行期间没有门诊就诊相关的因素,分别。
■在2351名活跃参与者中,76.0%为男性,57.6%年龄≥50岁,40.7%的非西班牙裔白人,38.2%非西班牙裔黑人,17.3%西班牙裔/拉丁裔,51.0%的公众保险。从2020年到2022年年中,每月的面对面和远程医疗就诊率各不相同。多变量逻辑回归显示,没有遇到的人更可能是男性或VL≥200拷贝/mL。对于具有≥1个VL测试的参与者,2020年HIVVL≥200拷贝/mL的患病率接近2014年至2019年的患病率.病毒抑制概率的变化与参与者的年龄无关,性别,种族/民族或保险类型。
■在大流行期间,由于远程医疗和面对面活动的变化,这些接触在过去的两年中有所减少,与病毒抑制的相对维持。从COVID-19对门诊护理的影响中持续恢复将需要继续努力,以改善保留率和患者获得医疗服务的机会。