HIV TREATMENT OUTCOMES IN RURAL GEORGIA USING TELEMEDICINE

Background The dearth of specialized healthcare services contributes to the ongoing HIV epidemic. Telemedicine (TM) is a potential tool to improve HIV care, but little is known about its effectiveness when compared to traditional (face-to-face) (F2F) care in rural populations. The objective of this study is to examine the effectiveness of HIV care delivered through TM compared to F2F care. Methods We conducted a retrospective chart review of a subset of HIV patients who attended TM clinic in Dublin Georgia, and conventional F2F clinic in Augusta, Georgia between May 2017 to April 2018. All TM patients were matched to F2F patients based on gender, age, and race. HIV Viral Load (VL) and gain in CD4 counts were compared using T-test and Snedecor Statistics. Results 385 patients were included in the analyses (F2F=200, TM=185). Mean CD4 in the TM group was higher (643.9 cells/mm3) than the F2F group (596.3 cells/mm3) (p< 0.001). There was no statistically significant difference in VL reduction and control. Thirty-eight of eighty-five patients with detectable VL achieved viral suppression during the study period (F2F = 24/54, TM =14/31), with a mean change of −3.34 × 10 4 and −1.24 × 10 4 respectively, p = 1.00. Mean VL was F2F = 416.8 cp/ml, TM = 713.4 cp/ml, p = 0.3. Conclusion TM was associated with outcome measures comparable to F2F. Increased access to specialty HIV care through TM can facilitate HIV control in communities with limited healthcare access in rural US. Rigorous prospective evaluation of TM for HIV care effectiveness is warranted. Article Summary Telemedicine can be useful in improving access to specialist outpatient care for HIV and other chronic diseases, in remote communities with limited resources. Telemedicine can lead to similar outcomes when compared to traditional face-to-face outpatient consultations. This is especially true currently with COVID-19.