JMIR Publications

ABSTRACT

Background:

Approximately 1.1 million people with HIV (PWH) live in the United States and incidence is highest in the South. Electronic patient portal (EPP) prevalence is increasing and can improve engagement in primary medical care. Retention in care (RIC) and viral suppression (VS), measures of engagement in HIV care, are associated with decreased HIV transmission, morbidity, and mortality. We sought to determine if EPP access among PWH was associated with RIC and VS.

Objective:

We conducted an observational cohort study among PWH in care at the Vanderbilt Comprehensive Care Clinic (Nashville, Tennessee) from 2011-2016.

Methods:

Individual EPP access was defined as EPP account registration at any point in the year prior. RIC was ≥2 kept appointments or HIV lab measurements ≥3 months apart within a 12-month period. VS was the last viral load in the calendar year of interest <200 copies/mL. We calculated adjusted prevalence ratios (aPR) and 95% confidence intervals (CI) using modified Poisson regression with generalized estimating equations to estimate the association of EPP access with RIC and VS.

Results:

We included 4,237 PWH contributing 16,951 person-years (p-y) of follow-up (median=5; IQR=3-5 p-y). Median age was 43 years (IQR=33-50); 78.1% were male, 40.8% were Black non-Hispanic, and 56.5% had EPP access. EPP access was independently associated with RIC (aPR=1.13 [95% CI, 1.10-1.17]) and VS (aPR=1.18 [95% CI, 1.14-1.22]).

Conclusions:

In this population, EPP access was associated with RIC and VS. Future prospective studies should assess the impact of increasing EPP access among PWH on these HIV outcomes.