Telehealth Attendance Higher Than In-Person Among HIV Patients

HIV appointments conducted through telehealth resulted in higher attendance rates than those done in-person, according to a study published in AIDS and behavior.

The study, conducted in a safety-net hospital-based outpatient infectious disease clinic in Chicago, included 347 patients with HIV, 251 of whom were black, and 217 male. The mean age of the sample was 44.2 years old.

All patients had to be 18 years of age, have experience with at least one HIV telehealth visit between March 2020 and May 2021, and experience with at least one HIV in-person visit between January 2017 and May 2021.

During the study period, the attendance rate for telehealth appointments was 78.9 percent, substantially higher than the 61.9 percent for in-person visits. As a result of the changes in healthcare delivery during the COVID-10 pandemic, many patients with HIV found visits through telehealth to be far more accessible than in-person care, according to the study.

There was no correlation between sex, age, and a preference for telehealth among HIV patients, but there were differences in preference tied to race, housing status, and substance use.

The data shows that Black HIV patients had a higher rate of telehealth usage compared to patients of other races, which was 19.9 percent higher than in-person appointment attendance.

But despite this tremendous increase in telehealth engagement, there were various instances where patients could not participate in virtual care due to factors such as housing and substance use issues.

Patients with substance use issues had a 19.4-percentage point lower in-person attendance rate than those without those issues, and patients in unstable housing arrangements had a 15-percentage point lower in-person attendance rate than those with stable housing.  

Observing that appointments through telehealth are generally more prevalent among patients with HIV, researchers concluded that removing barriers for those who cannot access virtual care is a must. Considering that most patients, including those who have poorer living conditions and substance use issues, prefer telehealth, eliminating problems with the digital divide will likely promote HIV care.

The study does have various limitations, however, all of which relate to the data used in the study.

Regarding the sample, participants came from a specific urban environment, and most of the population was black and male. Also, the pandemic likely influenced responses, considering the everyday use of telehealth during that time.

In addition, due to its flexibility, the various modalities used to conduct telehealth visits could have impacted data. These modalities did not distinguish between past and current substance use.

And, of course, utilization of EHRs involves a risk of neglecting data.

Telehealth’s success in delivering care to patients with HIV opens many new opportunities but first, barriers must be torn down.  

As methods of providing virtual HIV care are created, acknowledging common barriers is essential. Lack of resources was often a limiting factor for some individuals, and even with the right resources, many found the setting to be impersonal preventative of emotional expression, a previous study shows. Additionally, locating a private setting for the virtual visit was often tricky, though necessary, since this is needed to maintain confidentiality during appointments.