Evaluation of the virtual care experience for persons in prospective cohorts with HIV during the COVID pandemic

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.