{"doi":"10.1371/journal.pone.0320911","title":"Telehealth and in-person HIV care during the COVID-19 pandemic at a large academic medical center in North Carolina","abstract":"<jats:sec id=\"sec015\">\n<jats:title>Background</jats:title>\n<jats:p>To maintain HIV care during the COVID-19 pandemic, many HIV clinics across the United States adopted telehealth. However, not everyone participated in telehealth equally. This study assessed the use and disparities in telehealth and in-person HIV care at a large academic medical center in North Carolina (NC) relative to the COVID-19 pandemic.</jats:p>\n</jats:sec>\n<jats:sec id=\"sec016\">\n<jats:title>Methods</jats:title>\n<jats:p>Data from the Duke University Infectious Disease clinic in NC were extracted from electronic health records (EHR), aggregated across persons with HIV (PWH) by calendar month, visit type (in-person vs. telehealth HIV care), and by key sociodemographic and clinical characteristics. Variation in HIV care over time was analyzed graphically by age, sex, race and ethnicity, county of residence, and viral load (VL) history.</jats:p>\n</jats:sec>\n<jats:sec id=\"sec017\">\n<jats:title>Results</jats:title>\n<jats:p>EHR data from 2,623 PWH receiving care between January 2019 and March 2023 were included. Telehealth use sharply increased in the first months of the pandemic and decreased thereafter. Telehealth use was higher among non-Hispanic Whites compared to People of Color. Most PWH (93%) had a first post-onset-of-the-pandemic (<jats:italic>pop</jats:italic>) HIV care visit on March 16, 2020 and thereafter. The proportion of telehealth first <jats:italic>pop</jats:italic> visits peaked in April 2020 with 88% telehealth visits.</jats:p>\n</jats:sec>\n<jats:sec id=\"sec018\">\n<jats:title>Conclusions</jats:title>\n<jats:p>Telehealth bridged the initial COVID-19 pandemic phase with drastically reduced in-person visit availability, yet it was not equally utilized across race and ethnicity groups. To guide the optimal integration of telehealth in HIV care and promote equitable care in the future, HIV care outcomes need to be closely monitored, and strategies designed to promote access for Communities of Color are needed.</jats:p>\n</jats:sec>","journal":"PLOS One","year":2025,"id":633690,"datarank":0.10397207708399181,"base_score":0.6931471805599453,"endowment":0.6931471805599453,"self_citation_contribution":0.10397207708399181,"citation_network_contribution":0.0,"self_endowment_contribution":0.10397207708399181,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":430142,"name":"Jan Ostermann","orcid":"0000-0002-8236-9500","position":1,"is_corresponding":false},{"id":929022,"name":"Michael E Yarrington","orcid":"0000-0003-3186-1519","position":2,"is_corresponding":false},{"id":1643098,"name":"Andrew K Weinhold","orcid":null,"position":3,"is_corresponding":false},{"id":1428285,"name":"Nabil Natafgi","orcid":"0000-0003-4979-0317","position":4,"is_corresponding":false},{"id":295083,"name":"Bankole Olatosi","orcid":"0000-0002-8295-8735","position":5,"is_corresponding":false},{"id":295082,"name":"Sharon Weissman","orcid":"0000-0002-2854-5745","position":6,"is_corresponding":false},{"id":1643099,"name":"Nathan M Thielman","orcid":null,"position":7,"is_corresponding":false},{"id":772635,"name":"Valerie Yelverton","orcid":"0000-0002-9445-7022","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Telehealth and in-person HIV care during the COVID-19 pandemic at a large academic medical center in North Carolina","abstract":"<jats:sec id=\"sec015\">\n<jats:title>Background</jats:title>\n<jats:p>To maintain HIV care during the COVID-19 pandemic, many HIV clinics across the United States adopted telehealth. However, not everyone participated in telehealth equally. This study assessed the use and disparities in telehealth and in-person HIV care at a large academic medical center in North Carolina (NC) relative to the COVID-19 pandemic.</jats:p>\n</jats:sec>\n<jats:sec id=\"sec016\">\n<jats:title>Methods</jats:title>\n<jats:p>Data from the Duke University Infectious Disease clinic in NC were extracted from electronic health records (EHR), aggregated across persons with HIV (PWH) by calendar month, visit type (in-person vs. telehealth HIV care), and by key sociodemographic and clinical characteristics. Variation in HIV care over time was analyzed graphically by age, sex, race and ethnicity, county of residence, and viral load (VL) history.</jats:p>\n</jats:sec>\n<jats:sec id=\"sec017\">\n<jats:title>Results</jats:title>\n<jats:p>EHR data from 2,623 PWH receiving care between January 2019 and March 2023 were included. Telehealth use sharply increased in the first months of the pandemic and decreased thereafter. Telehealth use was higher among non-Hispanic Whites compared to People of Color. Most PWH (93%) had a first post-onset-of-the-pandemic (<jats:italic>pop</jats:italic>) HIV care visit on March 16, 2020 and thereafter. The proportion of telehealth first <jats:italic>pop</jats:italic> visits peaked in April 2020 with 88% telehealth visits.</jats:p>\n</jats:sec>\n<jats:sec id=\"sec018\">\n<jats:title>Conclusions</jats:title>\n<jats:p>Telehealth bridged the initial COVID-19 pandemic phase with drastically reduced in-person visit availability, yet it was not equally utilized across race and ethnicity groups. To guide the optimal integration of telehealth in HIV care and promote equitable care in the future, HIV care outcomes need to be closely monitored, and strategies designed to promote access for Communities of Color are needed.</jats:p>\n</jats:sec>","is_dataset_classified":null,"base_score":0.6931471805599453,"endowment":0.6931471805599453,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"40465553","pmcid":"PMC12136309","openalex_id":"https://openalex.org/W4411022225","authors":[],"funders":[{"funder_name":"Agency for Healthcare Research and Quality","grant_id":"R36HS029267","title":null},{"funder_name":"National Institute of Allergy and Infectious Diseases","grant_id":"5T32AI007392","title":null},{"funder_name":"National Institute of Allergy and Infectious Diseases","grant_id":"5P30 AI064518","title":null},{"funder_name":"Office of the Vice President for Research at University of South Carolina","grant_id":"SPARC Graduate Research Grant","title":null},{"funder_name":"NIAID NIH HHS","grant_id":"T32 AI007392","title":null},{"funder_name":"National Institutes of Health","grant_id":"5P30AI064518-17","title":"Centers for AIDS Research (CFAR)"},{"funder_name":"National Institutes of Health","grant_id":"1R36HS029267-01","title":"Patient experiences and disparities in telehealth HIV care during the COVID-19 pandemic: A mixed methods study from the Southern US"},{"funder_name":"National Institutes of Health","grant_id":"5T32AI007392-13","title":"INTERDISCIPLINARY RESEARCH TRAINING PROGRAM IN AIDS"}],"total_grants":8,"fwci":1.0701,"citation_percentile":0.76568957,"influential_citations":0,"citation_trend":[{"year":2025,"count":1}],"oa_status":"gold","license":"cc-by","oa_locations":[{"url":"https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0320911&type=printable","host_type":"journal"},{"url":"https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0320911&type=printable","host_type":"publisher"},{"url":"https://dx.plos.org/10.1371/journal.pone.0320911","host_type":"publisher"},{"url":"https://doi.org/10.1371/journal.pone.0320911","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/40465553","host_type":"repository"},{"url":"https://www.ncbi.nlm.nih.gov/pmc/articles/12136309","host_type":"repository"},{"url":"https://doaj.org/article/28cf2c4d6e854d058453602fca5022e5","host_type":"repository"},{"url":"https://doaj.org/article/80ed34e78868452294a72b99704ecc61","host_type":"repository"},{"url":"https://europepmc.org/articles/PMC12136309","host_type":"Europe_PMC"},{"url":"https://europepmc.org/articles/PMC12136309?pdf=render","host_type":"Europe_PMC"},{"url":"http://dx.doi.org/10.1371/journal.pone.0320911","host_type":""}],"fields_of_study":["Telemedicine and Telehealth Implementation","HIV/AIDS Research and Interventions","Mobile Health and mHealth Applications"],"mesh_terms":["Academic Medical Centers","COVID-19","SARS-CoV-2","Adolescent","Adult","Female","Humans","Male","Middle Aged","North Carolina","HIV Infections","Telemedicine","Viral Load","Young Adult","Electronic Health Records","Pandemics"],"keywords":["Telehealth","Pandemic","Ethnic group","Medicine","Family medicine","Residence","Telemedicine","Health care","Gerontology","Coronavirus disease 2019 (COVID-19)","Demography","Disease","Infectious disease (medical specialty)","Internal medicine","Male","Adult","Academic Medical Centers","Adolescent","SARS-CoV-2","Science","Q","R","COVID-19","HIV Infections","Middle Aged","Viral Load","Young Adult","North Carolina","Humans","Electronic Health Records","Female","Pandemics","Research Article"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Good health and well-being"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-06T12:29:46.760840Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}