Telehealth Interventions to Improve HIV Care Continuum Outcomes: A Narrative Review

Interventions that leverage telehealth technologies have the potential to improve health outcomes among people with HIV who experience multiple complex barriers to care. To assess the current state of knowledge on telehealth interventions for people with HIV in the United States, we searched the literature for recent (2019-2023) telehealth interventions designed to improve outcomes along the HIV care continuum, including linkage to care, retention in care, antiretroviral therapy adherence, and viral suppression. Our search identified 23 interventions. Text messaging was the most common telehealth delivery mode, followed by videoconferencing, commercially available applications, and novel applications. Nine interventions used more than one delivery mode. Common features across interventions to address barriers along the HIV care continuum included: HIV care self-management and monitoring tools; HIV treatment and adherence education; resources and referrals provision; live messaging for ongoing support or urgent issues; videoconference-based coaching, counseling, case management, or care; online peer-to-peer support; ecological momentary assessments to monitor and address barriers; and game-based elements to increase engagement. Interventions were reported as acceptable and feasible, with several showing an effect on antiretroviral therapy adherence. Further research is needed to fully leverage the potential of telehealth for ending the HIV epidemic in the United States.