Department of Medicine, University of California, San Francisco, San Francisco, CA 94105, USA.
AIDS Patient Care STDS. 2013 Sep;27(9):529-32. doi: 10.1089/apc.2013.0185.
Abstract Antiretroviral nonadherence is a strong determinant of virologic failure and is negatively correlated with survival. HIV-positive African American youth have lower antiretroviral adherence and treatment engagement than other populations. We assessed the feasibility and acceptability of a telehealth (remote videoconferencing) medication counseling intervention as an innovative approach to address these disparities. HIV-positive African American youth (18-29 years old) on antiretrovirals were enrolled in a telehealth medication counseling session, followed by a semi-structured qualitative interview to explore likes/dislikes of the format, modality, and content; potential impact on adherence; privacy issues; and interaction quality. Fourteen participants with a mean age of 24 years, who were 86% male, and had a mean self-reported adherence in the past month of 89%, were interviewed. Participants stated that they liked telehealth, would use it if offered in clinic/research settings, and indicated that their privacy was maintained. Participants described telehealth as convenient and efficient, with positive impact on their knowledge. Telehealth provided a modality to interact with providers that participants described as less intimidating than in-person visits. Telehealth is feasible and acceptable for delivering medication counseling to HIV-positive African American youth when conducted in a controlled clinical setting and may improve quality of patient-provider dialogue. Use of telehealth may lead to more disclosure of treatment difficulties, increased patient comfort, and improved health education.
摘要 抗逆转录病毒治疗不依从是病毒学失败的一个重要决定因素，并且与存活率呈负相关。与其他人群相比，HIV 阳性的非裔美国青年的抗逆转录病毒药物依从性和治疗参与度更低。我们评估了远程医疗（远程视频会议）药物咨询干预作为解决这些差异的创新方法的可行性和可接受性。正在接受抗逆转录病毒治疗的 HIV 阳性非裔美国青年（18-29 岁）参加了远程医疗药物咨询会议，随后进行了半结构化定性访谈，以探讨对该模式、方式和内容的喜好/不喜欢；对依从性的潜在影响；隐私问题；以及互动质量。对 14 名参与者进行了访谈，他们的平均年龄为 24 岁，其中 86%为男性，过去一个月的自我报告依从率为 89%。参与者表示他们喜欢远程医疗，如果在诊所/研究环境中提供，他们会使用它，并表示他们的隐私得到了维护。参与者将远程医疗描述为方便且高效，对他们的知识有积极影响。在受控的临床环境中，远程医疗为向 HIV 阳性非裔美国青年提供药物咨询提供了一种方式，可能会改善医患对话的质量。远程医疗的使用可能会导致更多地披露治疗困难，增加患者的舒适度，并改善健康教育。
