ArticleJournal of the International AIDS Society2021
HIV care using differentiated service delivery during the COVID-19 pandemic: a nationwide cohort study in the US Department of Veterans Affairs.
Article in Journal of the International AIDS Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 6 of them syntheses that pooled it.
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Who cites it
29 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Evaluating the impact of COVID-19 on the HIV care continuum across global income levels: a mixed-methods systematic review.AIDS research and therapy · 2025Pooled it
- Impacts of the COVID-19 Pandemic on the HIV Care Continuum and Associated Factors in High-Income Nations: A Mixed-Methods Systematic Review.AIDS and behavior · 2025Pooled it
- An Evidence Map of the Women Veterans' Health Literature, 2016 to 2023: A Systematic Review.JAMA network open · 2025Pooled it
- Impact of COVID-19 on Utilization of Healthcare Services Among People Living with HIV (PLHIV): A Systematic Review.Medicina (Kaunas, Lithuania) · 2025Pooled it
- HIV Testing Disruptions and Service Adaptations During the COVID-19 Pandemic: A Systematic Literature Review.AIDS and behavior · 2024Pooled it
- Syndemic effect of COVID-19 outbreak on HIV care delivery around the globe: A systematic review using narrative synthesis.Health promotion perspectives · 2023Pooled it
- Mental health and substance use screening in HIV primary care before and during the early COVID-19 pandemic.BMC health services research · 2023Trial
- What Tools Do We Have to End the US HIV Epidemic? A Review of Structural, Biomedical and Implementation Interventions and Their Potential Population Impact.Journal of the International AIDS Society · 2026Review
- Telemental Healthcare and HIV Care: A National Study of US Veterans with HIV during COVID-19.AIDS and behavior · 2026Article
- Sustained mental health impacts of COVID-19 among people living with and without HIV in the Dominican Republic.BMC public health · 2026Article
- Disruptions of healthcare visits and viral suppression for people living with HIV during the COVID-19 pandemic in the US.BMC infectious diseases · 2025Article
- Telehealth and in-person HIV care during the COVID-19 pandemic at a large academic medical center in North Carolina.PloS one · 2025Article
- Article
- Association between virtual visits and health outcomes of people living with HIV: A cross-sectional study.PloS one · 2025Article
- Emerging from the shadows: Trends in HIV ambulatory care, viral load testing, and viral suppression in a U.S. HIV cohort, 2019-2022: Impact of COVID-19 pandemic.Journal of investigative medicine : the official publication of the American Federation for Clinical Research · 2024Article
- Disparities in Telehealth Use in HIV Care During the COVID-19 Pandemic: Study Findings from South Carolina.Telemedicine journal and e-health : the official journal of the American Telemedicine Association · 2024Article
- Rural Veterans with HIV and Alcohol Use Disorder receive less video telehealth than urban Veterans.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2024Article
- Relationship Between Patient Portal Tool Use and Medication Adherence and Viral Load Among Patients Living with HIV.Journal of general internal medicine · 2024Article
- Using a Health Information Exchange to Characterize Changes in HIV Viral Load Suppression and Disparities During the COVID-19 Pandemic in New York City.Open forum infectious diseases · 2023Article
- Visit and Between-Visit Interaction Frequency Before and After COVID-19 Telehealth Implementation.JAMA network open · 2023Article
Corrections and comments
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Authors and funding
14 authors.
Funding
Abstract
introductionThe Department of Veterans Affairs (VA) is the largest provider of HIV care in the United States. Changes in healthcare delivery became necessary with the COVID-19 pandemic. We compared HIV healthcare delivery during the first year of the COVID-19 pandemic to a prior similar calendar period.
methodsWe included 27,674 people with HIV (PWH) enrolled in the Veterans Aging Cohort Study prior to 1 March 2019, with ≥1 healthcare encounter from 1 March 2019 to 29 February 2020 (2019) and/or 1 March 2020 to 28 February 2021 (2020). We counted monthly general medicine/infectious disease (GM/ID) clinic visits and HIV-1 RNA viral load (VL) tests. We determined the percentage with ≥1 clinic visit (in-person vs. telephone/video [virtual]) and ≥1 VL test (detectable vs. suppressed) for 2019 and 2020. Using pharmacy records, we summarized antiretroviral (ARV) medication refill length (<90 vs. ≥90 days) and monthly ARV coverage.
resultsMost patients had ≥1 GM/ID visit in 2019 (96%) and 2020 (95%). For 2019, 27% of visits were virtual compared to 64% in 2020. In 2019, 82% had VL measured compared to 74% in 2020. Of those with VL measured, 92% and 91% had suppressed VL in 2019 and 2020. ARV refills for ≥90 days increased from 39% in 2019 to 51% in 2020. ARV coverage was similar for all months of 2019 and 2020 ranging from 76% to 80% except for March 2019 (72%). Women were less likely than men to be on ARVs or to have a VL test in both years.
conclusionsDuring the COVID-19 pandemic, the VA increased the use of virtual visits and longer ARV refills, while maintaining a high percentage of patients with suppressed VL among those with VL measured. Despite decreased in-person services during the pandemic, access to ARVs was not disrupted. More follow-up time is needed to determine whether overall health was impacted by the use of differentiated service delivery and to evaluate whether a long-term shift to increased virtual healthcare could be beneficial, particularly for PWH in rural areas or with transportation barriers. Programmes to increase ARV use and VL testing for women are needed.
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