HIV care using differentiated service delivery during the COVID‐19 pandemic: a nationwide cohort study in the US Department of Veterans Affairs

• DOI: 10.1002/jia2.25810
• Publication Date: 2021-10-29T05:36:29Z
• Authors: Kathleen A. McGinnis; Melissa Skanderson; Amy C. Justice; Kathleen M. Akgün; Janet P. Tate; Joseph T. King; Christopher T. Re...; Vincent C. Marconi; Evelyn Hsieh; Christopher Ruser; Farah Kidwai‐Khan; Roozbeh Yousefzadeh; Joseph Erdos; Lesley S. Park
• Keywords: Veterans Affairs; Pandemic

The Department of Veterans Affairs (VA) is the largest provider HIV care in United States. Changes healthcare delivery became necessary with COVID-19 pandemic. We compared during first year pandemic to a prior similar calendar period.We included 27,674 people (PWH) enrolled Aging Cohort Study 1 March 2019, ≥1 encounter from 2019 29 February 2020 (2019) and/or 28 2021 (2020). counted monthly general medicine/infectious disease (GM/ID) clinic visits and HIV-1 RNA viral load (VL) tests. determined percentage visit (in-person vs. telephone/video [virtual]) VL test (detectable suppressed) for 2020. Using pharmacy records, we summarized antiretroviral (ARV) medication refill length (<90 ≥90 days) ARV coverage.Most patients had GM/ID (96%) (95%). For 27% were virtual 64% In 82% measured 74% Of those measured, 92% 91% suppressed refills days increased 39% 51% coverage was all months ranging 76% 80% except (72%). Women less likely than men be on ARVs or have both years.During pandemic, VA use longer refills, while maintaining high among measured. Despite decreased in-person services access not disrupted. More follow-up time needed determine whether overall health impacted by differentiated service evaluate long-term shift could beneficial, particularly PWH rural areas transportation barriers. Programmes increase testing women are needed.