Telemedicine As Effective As In-Person Visits for Delivering HIV Care

Telemedicine visits were found to be as effective as in-person visits in suppressing and controlling viral load in patients with HIV, according to a retrospective study published in Open Forum Infectious Diseases.

Investigators retrospectively reviewed the medical records of 2 groups of HIV patients, one who received care via telemedicine and one who received in-person care, between May 2017 and April 2018. All patients lived in rural communities in the southeast United States. Patients in both groups were matched according to gender, age, and race. The main outcomes measured were rates and maintenance of viral suppression during the study period.

The investigators included 200 in-person and 185 telemedicine patients with HIV in the final analyses; 82.1% of the patients with Black and 50.9% were women. Mean CD4 count was higher in the telemedicine group (643.9 cells/mm³) vs the in-person group (596.3 cells/mm³; P <.001). No significant difference was found between the groups’ viral load reduction, viral load control, mean viral load, or mean change in the number of patients who achieved viral suppression during the study period.

Limitations of this study include its observational design, which leaves room for selection bias, and the inclusion of only patients with stable disease.

The investigators noted that the patients in the telemedicine group would have had to travel at least 3 hours for an in-person infectious disease consultation. They also cited research that patients with HIV who reside in rural areas are more likely to be diagnosed with advanced disease, have higher mortality rates, have less access to care, and have lower treatment retention rates. As clinical outcomes were comparable among the telemedicine and in-person groups, the investigators propose that telemedicine can remove the barriers of geography and travel to quality HIV care.

“Expansion of telemedicine services to rural areas particularly in the southern United States will provide access to specialty HIV care with associated optimal viral suppression rates and a greater reduction in transmission rates, thus reducing the incidence of new cases,” the study authors conclude.

Reference

Lawal FJ, Omotayo MO, Lee TJ, Srinivasan Rao ASR, Vazquez JA. HIV treatment outcomes in rural Georgia using telemedicine. Open Forum Infect Dis. Published online May 12, 2021. doi:10.1093/ofid/ofab234