患者在佐治亚州亚特兰大市第一波 COVID-19 期间接受 HIV 护理的远程医疗体验。

Patient Experiences with Telemedicine for HIV Care During the First COVID-19 Wave in Atlanta, Georgia.

机构信息

Indiana University School of Public Health, Bloomington, Indiana, USA.

Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, USA.

出版信息

AIDS Res Hum Retroviruses. 2022 May;38(5):415-420. doi: 10.1089/AID.2021.0109. Epub 2021 Nov 29.

Abstract

We explored experiences with telemedicine among persons with HIV (PWH) during the first wave of the coronavirus disease 2019 (COVID-19) pandemic. A convenience sample of adults (>18 years) receiving care in an urban clinic in Atlanta were invited to participate. Patients completed a structured survey that assessed the usefulness, quality, satisfaction, and concerns with telemedicine services (telephone calls) received during the first wave of the COVID-19 pandemic (March-May 2020). Demographic, plasma HIV-1 RNA, and CD4 T cell count data were obtained through medical chart abstraction. Bootstrapped -tests and chi-square tests were used to examine differences in patient experiences by age, sex, and race. Of 406 PWH contacted, 101 completed the survey (median age 55 years, 84% men, 77% Black, 98% virally suppressed, median CD4 count 572 cells/μL). The main HIV care disruptions experienced were delays in follow-up visits (40%), difficulty getting viral load measured (35%), and difficulty accessing antiretroviral therapy (21%). Participant ratings for quality (median score 6.5/7), usefulness (median score 6.0/7), and satisfaction (median score 6.3/7) with telemedicine were high. However, 28% of patients expressed concerns about providers' ability to examine them and about the lack of laboratory tests. More women had concerns about providers' ability to examine them (92% vs. 50%,  = .005) and about the safety of their personal information (69% vs. 23%,  = .002) compared with men. No age or race differences were observed. Although PWH are generally satisfied with telephone-based telemedicine, concerns with its use were notable, particularly among women. Future HIV telemedicine models should address these.

摘要

我们探讨了在 2019 冠状病毒病(COVID-19)大流行第一波期间艾滋病毒感染者(PWH)使用远程医疗的体验。在亚特兰大的一家城市诊所,邀请了方便的成年人(>18 岁)参加。患者完成了一项结构调查,评估了他们在 COVID-19 大流行第一波期间(2020 年 3 月至 5 月)接受的远程医疗服务(电话)的有用性、质量、满意度和顾虑。通过病历摘要获取人口统计学、血浆 HIV-1 RNA 和 CD4 T 细胞计数数据。采用自举检验和卡方检验来检查年龄、性别和种族对患者体验的差异。在联系的 406 名 PWH 中,有 101 名完成了调查(中位年龄 55 岁,84%为男性,77%为黑人,98%病毒抑制,中位 CD4 计数 572 个/μL)。主要的艾滋病毒护理中断包括随访就诊延迟(40%)、难以测量病毒载量(35%)和难以获得抗逆转录病毒治疗(21%)。患者对远程医疗质量(中位数评分 6.5/7)、有用性(中位数评分 6.0/7)和满意度(中位数评分 6.3/7)的评分较高。然而,28%的患者对提供者检查他们的能力以及缺乏实验室检查表示担忧。与男性相比,更多的女性对提供者检查他们的能力(92%比 50%,=0.005)和他们个人信息的安全性(69%比 23%,=0.002)表示担忧。未观察到年龄或种族差异。尽管 PWH 通常对基于电话的远程医疗感到满意,但对其使用的担忧值得注意,尤其是在女性中。未来的 HIV 远程医疗模式应解决这些问题。

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