HIV Specialist - March 2021 - 12

TOGETHER w
BY: Joseph S. Cervia, MD, MBA, FACP, FAAP, FIDSA, AAHIVS

''H

I DR. JOE, it is great to be with you...if only
virtually! " I suspect that many of us have been
hearing greetings of this sort frequently this past
year. Although we may have previously utilized
telephone, electronic information and digital communication
technologies in the care of our patients, the COVID-19
pandemic has driven dramatic growth in telehealth visits
over the past year. Telehealth is broadly defined as the use of
electronic information and telecommunication technologies to
support and promote long-distance clinical healthcare, patient
education, public health and health administration.1 During
the first quarter of 2020, the number of telehealth visits in the
U.S. increased by 50 percent, compared with the same period in
2019, with a 154 percent increase in visits noted in surveillance
week 13 in 2020, compared with the same period in 2019.2

Throughout recorded history, pandemics have taught humanity
a great deal: driving progress in biomedical science, public health
and health care delivery. And such calamities will continue to teach
us if we remain attentive, adaptive and humble enough to learn. The
past year has certainly motivated progress in each of these areas.
Nevertheless, many challenges and opportunities remain. In battling
the dual pandemics of HIV/AIDS and SARS-CoV-2/COVID-19,
telehealth has offered numerous important opportunities to address
critical challenges in delivering care for individuals living with HIV.

Eliminating Geographic Barriers

For decades, it has been recognized that limited geographic access
to HIV specialty services in rural areas has been problematic. Rural
residents are less likely to get tested for HIV, more likely to internalize
HIV-related stigma, more likely to be tested in non-rural places, more
likely to be diagnosed with AIDS at the time of initial HIV diagnosis
and less likely to be retained in care as well as be virally suppressed.3
In rural states, there is a general shortage of clinical providers,
pervasive barriers to providing care, and community stigma around
HIV and its risk factors.4 Although there have been repeated efforts

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to recruit skilled healthcare professionals to
these areas, they have frequently fallen short
of what is needed to assure enhanced outcomes for individuals at risk for or infected
with HIV.
Telehealth services offer the potential to
eliminate geographic barriers to HIV care.
As we have learned in this past year, physical
distances and geopolitical boundaries need
not prove to be insurmountable. During the
COVID-19 pandemic, many states have altered or eliminated licensing requirements for
telehealth services, allowing broader access
to quality primary and specialty care.5 If some
of these changes are continued, expanded,
and made permanent, telehealth may grow to
assume a pivotal role in rendering geographic
barriers to high quality HIV care obsolete.

Minimizing
Transportation Issues

In both urban and suburban environments,
transportation to and from regular healthcare visits can be costly and difficult, and can
thus challenge engagement and adherence
for individuals living with HIV. Inclement
weather, traffic and public transportation
infrastructure issues can often complicate
the efforts of even the most conscientious patients and providers. Moreover, homebound
individuals and others with mobility issues
may face even greater difficulties with multiple recurring appointments for in-person
visits to various healthcare services.
Telehealth can eliminate the need for
patients and providers to travel, increasing
efficiency and reducing cost. It also reduces
the number of missed visits attributable to


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HIV Specialist - March 2021

Table of Contents for the Digital Edition of HIV Specialist - March 2021

HIV Specialist - March 2021 - Cover1
HIV Specialist - March 2021 - Cover2
HIV Specialist - March 2021 - 1
HIV Specialist - March 2021 - 2
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HIV Specialist - March 2021 - Cover3
HIV Specialist - March 2021 - Cover4
https://www.nxtbook.com/ygsreprints/AAHIVM/hiv-specialist-march-2021
https://www.nxtbook.com/ygsreprints/AAHIVM/G121337_AAHIV_122020
https://www.nxtbook.com/ygsreprints/AAHIVM/G119632_AAHIV_092020
https://www.nxtbook.com/ygsreprints/AAHIVM/G118334_AAHIV_062020
https://www.nxtbook.com/ygsreprints/AAHIVM/G116663_AAHIVM_032020
https://www.nxtbookmedia.com