HIV service providers changed their practices quickly once the COVID-19 pandemic hit but are struggling with financial and other issues, a Kaiser Family Foundation survey of Ryan White Care Act-funded HIV services found.
The survey was conducted between August 18 and September 4, 2020. Before the novel coronavirus, 22% of 161 survey respondents reported that they offered telehealth services; that proportion increased to 99% during the pandemic. These virtual visits have improved retention in care and helped to reach young people, but also leave out unstably housed people and those living in rural areas without broadband infrastructure, among others, survey respondents generally agreed.
As the pandemic continues, lack of laboratory work is becoming a concern. Eighty-nine percent of respondents said they now provide multi-month antiretroviral prescriptions and 70% offer on-site COVID testing, but they often do so with fewer resources: 27% of respondents reported staff layoffs or furloughs, and another 27% reported a reduction in staff hours—despite 30% of respondents reporting that they had seen an increase in new clients.
Forty percent of respondents said their clients’ insurance mix had changed: More people are uninsured or have lost private coverage, and more people rely on Medicaid than before the pandemic, with the financial effects of those changes being felt by care providers.
Other issues raised by the survey included insufficient PPE (reported by 10% of respondents), insufficient access to COVID testing (22%), and not enough space to allow for social distancing at the clinic (32%).