In response to the COVID-19 pandemic, we scaled up telemedicine and rideshare services for clinic and laboratory visits for pediatric and adolescent patients with HIV.
HIV subspecialty program for patients aged 0-24 years at Children’s National Hospital, Washington, DC.
Using chi-squared and Wilcoxon rank sum tests, we compared demographic, visit and laboratory data, and rideshare usage among patients who scheduled telemedicine at least once (telemedicine) versus those who never scheduled telemedicine (no-telemedicine) during the pandemic (April-September 2020). We compared the number and proportion of scheduled and completed clinic visits before the pandemic (April-September 2019) with those during the pandemic.
We analyzed 178 pediatric and adolescent patients with HIV (median age 17.9 years, 89.3% Black, 48.9% male, 78.7% perinatally infected), of whom 70.2% and 28.6% used telemedicine and rideshare, respectively. Telemedicine patients scheduled more visits (236 versus 179, p<0.0001) and completed a similar proportion of visits (81.8% versus 86.0%, p=0.3805) compared to no-telemedicine patients. Laboratory testing rates (81.3% versus 98.5%, p=0.0005) were lower in telemedicine compared to no-telemedicine patients. Rideshare usage (12.4% versus 26.5%, p=0.0068) was lower in telemedicine versus no-telemedicine patients. During the pandemic, most patients (81.0%) had HIV RNA <200 copies/mL. The total number of completed visits and the proportion of visits completed were similar before and during the pandemic.
The majority of pediatric and adolescent patients with HIV used telemedicine and maintained HIV RNA <200 copies/mL during the pandemic. Despite rideshare usage, laboratory testing rates were lower with telemedicine compared to in-person visits.