Description of a Telemedicine Clinic that Materially Advances the Treatment of Human Immunodeficiency Virus-infected Patients

Care of patients infected with the Human Immunodeficiency Virus (HIV) in the United States and Europe is mainly outpatient, where treatment is most efficiently provided using Telemedicine. The goal of treatment is the suppression of viral replication, accomplished by placing patients on anti-retroviral therapy early in the process of disease. Viral suppression is then verified by polymerase chain reaction. Anti-retroviral regimens suppress the virus in >95% of patients who adhere to an appropriate regimen. Consequently, the physician’s role in follow up of patients is to encourage adherence to anti-retroviral therapy, a task achievable through Telemedicine clinics. We describe the features of a Telemedicine clinic established in 2006 for residents and incarcerated individuals in the state of Arizona with HIV infection. Important structural and functional elements of the clinic are presented and discussed. Outcomes of the Telemedicine clinic are compared to those achieved in a traditional Brick-and-Mortar clinics. The clinic also provides care for individuals desiring Post-Exposure Prophylaxis, and Pre-Exposure Prophylaxis against HIV. This Telemedicine clinic has successfully served the needs of thousands of HIV-infected residents of the state of Arizona.