What to Know About Telehealth for HIV/AIDS

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Healthcare providers treating people living with human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) have been utilizing telehealth for several years. But like nearly all other medical fields, it has become increasingly popular.

Stethoscope And Mobile Phone

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Telehealth and COVID-19

With the spread of COVID-19, telehealth has become an attractive alternative to in-person healthcare appointments. While healthcare offices and clinics are taking measures to keep staff and patients safe, refraining from going to public places—unless necessary—is a good practice during a pandemic.

When to Use Telehealth for HIV/AIDS

Not every visit with a doctor, nurse, or other healthcare professional requires physically going into their office. This holds true for people living with HIV/AIDS.

In fact, given the compromised immune systems of people with HIV/AIDS, it's a practice that makes sense to avoid unnecessary trips to a medical facility alongside people with a variety of other infectious conditions.

Some of the scenarios when telehealth can be used effectively for HIV/AIDS appointments include:

  • Routine check-ups for people with well-managed HIV/AIDS
  • Approving refills for existing prescriptions
  • Checking on adherence to treatments
  • General monitoring of patients
  • Visual assessments that can take the place of physical examinations
  • HIV/AIDS-related counseling services
  • Providing information on HIV/AIDS prevention strategies
  • Initial consultation for those interested in pre-exposure prophylaxis (PrEP)

You May Need to Be Seen In Person If…

Despite the increasingly widespread availability of telehealth to treat HIV/AIDS, there are still some situations in which a healthcare professional or doctor would ask a patient to visit them in-office. These scenarios include:

  • When blood work or any other lab testing is required.
  • When a healthcare practitioner spots something unusual during a visual assessment via telemedicine and requires the patient to come in for further examination.
  • When a patient's HIV/AIDS symptoms are not managed and they need in-person medical care and/or treatment.

Benefits and Challenges

While telehealth may be beneficial to some people living with HIV/AIDS, that's not universally the case. Along with the benefits, there are also some significant challenges to providing this type of care.

Benefits of Using Telehealth for HIV/AIDS

  • Appointments are more convenient—especially for people with compromised mobility
  • Allows immunocompromised patients to continue some aspects of their routine care without having to go to the office in-person during the COVID-19 pandemic, or other infectious disease outbreak
  • May increase accessibility of HIV/AIDS care for people in rural/underserved regions
  • Avoids having to schedule an in-person appointment to get refills on routine prescriptions every few months
  • May increase adherence to HIV/AIDS medications or other treatments
  • Can potentially reduce healthcare costs
  • May provide more opportunities for people with HIV/AIDS to receive emotional support

Likelihood of Receiving Treatment

An April 2020 study of 371 people living with HIV/AIDS found 57% of respondents were more likely to use telemedicine for their HIV care compared to in-person; 37% reported that they would use telehealth frequently or always as an alternative to clinic visits

Challenges of Using Telehealth for HIV/AIDS

  • Some routine procedures may require special telehealth equipment that not all doctors and patients are able to access
  • Not all liability insurers cover telemedicine malpractice
  • Video visits require a strong internet connection and a computer and/or smartphone—something that isn't universally available yet
  • Requires a significant investment on the side of the healthcare facility to purchase all the equipment needed to conduct telehealth visits
  • Maintaining a patient's privacy and security is of particular importance for some people living with HIV/AIDS, and protecting it may be a challenge for some providers
  • Some people living with HIV/AIDS may prefer to see their healthcare provider in person, and may not find communicating as easy during telehealth appointments
  • Still need to have routine labs drawn, including but not limited to CD4 counts, HIV viral loads, etc.

How to Prepare for a Telehealth Visit for HIV/AIDS

Before anything else, you'll need to find and/or select a healthcare provider that offers telehealth visits for people living with HIV/AIDS.

If you had been seeing a particular practitioner regularly, check-in with the office to see what kinds of telehealth options are available (if any). And while most insurance providers are covering telehealth visits, double-check with the office before making an appointment.

If you don't already have a regular healthcare provider, you can search for one in your area using an online tool like Zocdoc, which indicates whether an office offers telehealth visits (as well as whether they take your insurance, if applicable). You can also book an appointment through a company that exclusively offers telehealth, like Teledoc, One Medical, or Chiron.

Prior to your telehealth appointment with a medical professional, there are a number of ways you can prepare ahead of time, in order to maximize your time with the healthcare provider. These include:

  • Confirming who your appointment is with (a general practitioner, an infectious disease specialist, an immunologist, physician assistant, nurse practitioner, etc) so you know who to expect.
  • Checking with your doctor's office and/or insurance provider (if applicable) to confirm coverage.
  • Finding out whether the appointment will be over video, or whether it can and/or will be over audio-only.
  • Making sure you have a strong internet and/or phone signal prior to the appointment.
  • Thinking ahead about answers to information you might be asked for (i.e. how long certain symptoms have been occurring, if you've noticed any correlation between physical and mental health symptoms, etc.).
  • Having a list of questions you'd like to ask the doctor ready to go, as well as a note with your symptoms, medications, and health history (if needed).
  • If any aspect of your appointment involves a physical examination, ask the provider's office about their privacy and security measures. Alternatively, ask if taking photos of the affected areas ahead of time and sending them via a secure email would be a better option.
  • If a visual assessment is taking place, be sure to wear clothing that makes that part of your body easily accessible.
  • If video is involved, be sure to pick a private, brightly-lit room for your visit.
  • Downloading and testing the video or phone call platform their provider uses (if applicable).

Will Insurance Cover Telehealth for HIV/AIDS?

Insurance coverage can vary for telehealth appointments:

  • Federal guidelines on insurance coverage and telehealth are changing constantly.
  • Insurance coverage can vary significantly based on your home state, so be sure to check on the latest guidelines before making any telehealth appointments.
  • Like in-person appointments, being uninsured or underinsured might affect telehealth availability.

What Happens During the Visit

Prior to your telehealth visit, the doctor's office should provide you with a set of instructions and guidelines for the appointment, including:

  • What type of examination will (or will not) occur on camera
  • How your security and privacy will be managed

If this doesn't happen, ask questions about how the appointment will work prior to your visit.

If the healthcare provider needs you to take your own vitals—like your temperature and/or blood pressure—they will mention this to you ahead of the appointment and make sure you have the equipment necessary.

In general, telehealth visits for people living with HIV/AIDS are similar to other telehealth appointments the same steps:

  1. Using the link provided to you by the office, you'll sign into the platform and stay in a virtual "waiting room" until the medical professional is able to see you.
  2. Then, you'll discuss the reason for your visit—whether it's for a birth control prescription refill, or a rash or suspected infection, or to discuss an ongoing health concern.
  3. If any type of visual examination is required, the healthcare professional will walk you through how, exactly, to do that.
  4. Don't forget to ask any questions you had prepared ahead of your appointment, or that have come up during the visit.
  5. The visit will typically end with a summary of what has been discussed, diagnosed, or prescribed.
  6. The doctor should confirm that any prescriptions have been sent to your pharmacy of choice (if that doesn't happen, you should ask about it) and let you know if you can expect to continue using telehealth for future visits.

If the healthcare provider needs you to come to the office for an in-person visit for testing or a closer examination, they will let you know and provide information for booking that appointment.

A Word From Verywell

Telehealth appointments for people living with HIV/AIDS can include refilling a prescription for an antiretroviral treatment you've been on for years, or any type of counseling, monitoring, or follow-up visits that don't require a physical examination.

Of course, given the nature of HIV/AIDS and its impact on a person's immune system, certain exams, tests, and procedures will continue to be done in person.

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Article Sources
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