Division of Infectious Diseases, Department of Medicine, University of Missouri, Columbia, Missouri, USA.
Department of Management, Policy, and Community Health, School of Public Health, The University of Texas, Health Science Center at Houston, Houston, Texas, USA.
AIDS Patient Care STDS. 2020 Apr;34(4):166-172. doi: 10.1089/apc.2019.0261.
Telehealth could address many of the factors identified as barriers for retention in HIV care. In this study, we explore people with HIV (PWH)'s attitudes about using telemedicine for HIV care instead of face-to-face clinic visits. We administered a one-time survey to PWH presenting to an outpatient HIV center in Houston, Texas, from February to June 2018. The survey items were used to assess PWH's attitudes toward and concerns for telehealth and explanatory variables; 371 participants completed the survey; median age was 51, 36% and were female, and 63% was African American. Overall 57% of respondents were more likely to use telehealth for their HIV care if available, as compared with one-on-one in-person care, and 37% would use telehealth frequently or always as an alternative to clinic visits. Participants reported many benefits, including ability to fit better their schedule, decreasing travel time, and privacy but expressed concerns about the ability to effective communication and examination and the safety of personal information. Factors associated with likelihood of using telehealth include personal factors (US-born, men who have sex with men, higher educational attainment, higher HIV-related stigma perception), HIV-related factors (long-standing HIV), and structural factors (having difficulty attending clinic visits, not knowing about or not having the necessary technology). There was no association between participants with uncontrolled HIV, medication adherence, and likelihood of using telehealth. Telehealth programs for PWH can improve retention in care. Availability and confidence using various telehealth technologies need to be addressed to increase acceptability and usage of telehealth among PWH.
远程医疗可以解决许多被认为是阻碍艾滋病毒护理保留的因素。在这项研究中，我们探讨了艾滋病毒感染者（PLHIV）对使用远程医疗进行艾滋病毒护理而不是面对面诊所就诊的态度。我们在 2018 年 2 月至 6 月期间向德克萨斯州休斯顿的一家门诊艾滋病毒中心的 PLHIV 进行了一次性调查。调查项目用于评估 PLHIV 对远程医疗的态度和关注以及解释变量；371 名参与者完成了调查；中位数年龄为 51 岁，36%为女性，63%为非裔美国人。总体而言，与面对面的个人护理相比，57%的受访者更愿意在远程医疗可用的情况下使用远程医疗进行艾滋病毒护理，如果可以的话，37%的受访者将经常或总是使用远程医疗来代替诊所就诊。参与者报告了许多好处，包括更能适应他们的日程安排、减少旅行时间和隐私，但对有效沟通和检查能力以及个人信息安全表示担忧。与使用远程医疗可能性相关的因素包括个人因素（在美国出生、男男性行为者、更高的教育程度、更高的艾滋病毒相关耻辱感）、艾滋病毒相关因素（长期艾滋病毒）和结构因素（难以参加诊所就诊、不知道或没有必要的技术）。未感染者的 HIV 控制情况、药物依从性与使用远程医疗的可能性之间没有关联。为 PLHIV 提供的远程医疗计划可以提高护理保留率。需要解决远程医疗各种技术的可用性和使用信心，以提高 PLHIV 对远程医疗的接受度和使用率。
