So Close, Yet Too Far: How Telepsychiatry Is Shaping the Delivery of Mental Health to People Living with HIV in Rural/Urban USA and Abroad - An HIV/AIDS Psychiatry SIG-sponsored Symposium

As healthcare systems moved in person clinic visits online, the COVID-19 pandemic folded into another existing pandemic related to healthcare disparities, inequity and access to care. The abrupt transition and adoption of virtual visits for these individuals highlighted issues related to access. For some, it brought about unexpected benefits. Virtual visits have helped decrease the anxiety of requesting time off of work or time away from work with resultant lost wages, the juggling of childcare or caring for elders, or transportation-related issues. Many others have contended with new challenges including spotty, absent or unreliable Wi-Fi or internet service, computer literacy, distractions and lack of privacy. Some patients have embraced the experience of the “home visit”; others feel tethered to the computer and disconnected. HIV psychiatrists will provide an overview and then discuss the care of people living with HIV/AIDS (PLWHA) in different world settings: New York City, the Philippines and in rural southwest Virginia. Furthermore, mobile health intervention created at the University of Virginia by two HIV providers will be introduced: created for PLWHA with specific attention to diversity, equity and inclusion, it has been shown to improve clinical outcomes and also minimize technological barriers during the pandemic.

Dr. Luís Pereira, an HIV/AIDS and CL psychiatrist at Columbia University will provide a literature review and an overview of the benefits and drawbacks of telepsychiatry for vulnerable and underserved populations, focusing on barriers to care.

Dr. Roberta De Oliveira, lead psychiatrist at a bilingual hospital-based, academically affiliated low threshold HIV center provides HIV primary care to a predominantly poor, minority and immigrant patient population in New York City. In this service’s catchment area, the risk of HIV transmission, disease progression and death from AIDS is nearly double the New York City average. She will discuss the uptake of telepsychiatry among this patient population, the advantages and disadvantages of telepsychiatric care, as well as the barriers to remote visits among patients who have continued to utilize in person visits throughout the pandemic.

Dr. Mary Ann Joy Aguadera, an HIV psychiatrist from Manila, Philippines, will share a clinic's experience and the initiative in taking care of persons living with HIV as well as psychosocial support and psychological first aid for the health care providers in the HIV treatment HUB in the Philippines during the pandemic.

Dr. Gabrielle Marzani, an HIV Psychiatrist at the University of Virginia will share data on "no show" rates in an HIV clinic as a result of a shift to telepsychiatry with the implementation of a novel platform known as Positive Links and highlight the use of telemedicine in psychiatry, psychology and substance use disorder therapy for patients, including vulnerable and underserved patients in remote parts of rural Virginia.