Evaluation of the virtual care experience for persons in prospective cohorts with HIV during the COVID pandemic.
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abstract
The COVID pandemic necessitated shifting to virtual care. Our aim was to describe, and identify the challenges and satisfaction with the virtual care experience of a subset of participants from two established Canadian Trials Network (CTN) cohorts: CTN 222 (HIV/HCV coinfection) and CTN 314: CHANGE HIV (Correlates of Healthy Aging in geriatric HIV infection) - persons > 65 years age. We hypothesized that vulnerable populations could face challenges with virtual care related to age, mental health or drug addiction. Consenting participants provided demographic information, completed a non-validated 18-item self- administered questionnaire on their virtual care experience, and reported HIV specific laboratory collection and prescription refills during the COVID pandemic. Data on CD4 T lymphocyte counts and HIV viral loads were extracted from medical records. A total of 454 individuals participated between February 2021 and March 2023, including 133 from CTN 314 and 321 from CTN 222. Overall, 55.3% engaged in virtual care. In multivariable regression models (analysis with SAS and R software) use of virtual care was higher in the aging cohort (p < .0001) but did not vary with current alcohol, drug use or self-reported depression (p > .05). The most common reason for not engaging was that it was failure to offer. Of those who engaged, 55% reporting being very satisfied, 36.3% somewhat satisfied, and 8.8% not satisfied. Ten percent of the older and 16% of the HCV cohort, reported technology difficulties as a barrier to use. Those with a detectable HIV viral load were more likely to engage in virtual care, p < .05. 81.3% of participants had HIV blood tests as frequently as before the COVID-19 pandemic. Despite high satisfaction, the majority (80%) prefers in person visits. When offering virtual care, clinics need to ensure all eligible patients are aware of how to access the services and consider patient needs and preferences.
