Characterizing the impact of COVID-19-related healthcare disruptions on viral suppression among persons living with HIV: lessons from an New York City-based health information exchange

Emma Tucker, VP&S Class of 2025

Name: Emma Tucker
School: Vagelos College of Physicians and Surgeons, Class of 2025
Mentor: Jason Zucker, MD

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An estimated 78% of the >129,000 people living with HIV (PLWH) in New York City are virally suppressed, which means the quantity of virus circulating in the blood is low (<200 copies/mL). HIV viral load suppression (VLS) is crucial for both keeping PLWH healthy and for preventing further HIV transmission. Antiretroviral therapy is highly effective in achieving VLS but requires consistent engagement with the healthcare system. We used laboratory data from Healthix, a large-scale regional health information exchange (HIE) encompassing over 24 million patients and 8,000 healthcare facilities in the greater New York region, to characterizethe impact of COVID-19-related healthcare disruptions on VLS among PLWH. From a cohort of individuals with any sexually transmitted infection test from January 1, 2018 and July 14, 2022 we used test names and Logical Observation Identifiers Names and Codes (LOINCs) to identify HIV viral load (VL) tests performed. We isolated 715,084 viral load tests representing 80,090 unique patients and 250 healthcare facilities. We established a cohort of 17,807 patients with VL results from at least two years including 2019 and 2021. HIV VL results were categorized as suppressed (<200 copies/mL), not suppressed (200-1000 copies/mL), and high (>1000 copies/mL). Analyses and tests of significance are forthcoming. To our knowledge, this study represents the first use of Healthix data to study access to care and health outcomes among PLWH. We anticipate that using large-scale HIE data will help overcome the issue of data fragmentation that has historically hindered the evaluation of HIV care in urban areas.