Telehealth Yields Similar Outcomes as In-Person HIV Treatment

The use of telehealth in HIV treatment for patients living in rural Georgia showed comparable results to in-person care, according to a study published in Open Forum Infectious Diseases. 

More than one million people above the age of 13 in the United States live with HIV. Many go for extended periods of time without treatment due to care disparities that hinder access to care, such as a lack of transportation or a lack of specialists in the area. In rural areas, those disparities are more pronounced, with patients often driving several hours to the nearest clinic or practice to receive treatment.

To test the value of a connected health platform in a rural area like Georgia, a research team from Augusta University and Massachusetts General Hospital looked at 185 individuals from the Dublin Department of Health HIV clinic database who used telehealth and compared their health outcomes with 200 individuals from the August University HIV clinic patient database who received traditional face-to-face treatment. The telemedicine participants received their treatment via two-way video conferencing with an infectious diseases physician.

Researchers compared the patients’ viral loads, the amount of HIV detected in their blood and CD4 counts, which detect the number of t-cells in the patient’s blood. Higher CD4 counts indicate better health while lower counts put the patient at a higher risk of illness. The main outcomes the researchers looked at were rates and maintenance of viral suppression, according to a press release accompanying the study.

According to the research team, outcomes weren’t any different between the two groups, indicating that a telehealth platform was just as effective in managing care as in-person treatments.

“Patients with HIV in rural areas are more likely to be diagnosed with advanced disease and to have higher mortality rates,” the study noted. “In addition, these same patients have more difficulty in finding access to care and have lower retention rates during care.”

The study holds promise for telehealth adoption in any rural area where residents face challenges in accessing in-person care. It might also apply to gaps in care caused by racial disparities.

The majority of both study cohorts were black individuals, making up 82 percent of the in-person group and 82.2 percent of the telemedicine group. Black and Hispanic communities are disproportionately affected by HIV compared to other racial and ethnic groups, according to HIV.gov.

“The use of telemedicine for long-term care of many chronic diseases including HIV can be a particularly useful resource in these physician-deprived areas,” researchers noted in the study. “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.”

Healthcare providers across the country have been using connected health tools and platforms to improve access to care and core outcomes for those living with HIV, in some cases designing programs to reduce the spread of the disease.

In late 2020, Stanford Children’s Health launched a virtual Pre-exposure Prophylaxis (PrEP) program that uses telehealth to connect patients with pediatric and adolescent healthcare providers. The program is designed to offer sexual health counseling, labs, and medication adherence support for PrEP, a daily HIV prevention pill.

"Virtual care allows us to meet youth where they are, even during transition to college or other moves, and offers an added layer of confidentiality, as it allows providers to communicate with patients one-on-one, without involving a parent or other guardian if that is the patient's preference," Geoff Hart-Cooper, MD, founder and medical director of the Virtual PrEP Program, said in a press release.