Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.
Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.
AIDS Patient Care STDS. 2023 Oct;37(10):459-468. doi: 10.1089/apc.2023.0176.
To ensure care continuity during the COVID-19 pandemic, telehealth has been widely implemented in human immunodeficiency virus (HIV) care. However, participation in and benefits from telehealth were unequal. This study aims to assess the willingness of people living with HIV (PWH) and HIV care providers to use telehealth and perceptions of the future role of telehealth. In-depth interviews with 18 PWH and 10 HIV care providers from South Carolina assessed their willingness to use telehealth, their perspectives on the future of telehealth in HIV care, and recommendations to improve telehealth. Interviews were analyzed using thematic analysis. Most PWH were female (61%), Black/African American (67%), and non-Hispanic (78%). Most PWH (61%) and all providers had used telehealth for HIV care. Most PWH and all providers reported being willing to use or (re-)consider telehealth HIV care services in the future. Providers suggested that telehealth is most suitable for routine HIV care encounters and for established, clinically stable, generally healthy PWH. Attitudes toward telehealth were heterogeneous, with most interviewees valuing telehealth similarly or superior to in-person care, yet >20% perceiving it less valuable. Recommendations to improve telehealth included multilevel strategies to address challenges across four domains: technology, the virtual nature of telehealth, administrative processes, and the sociodemographic profile of PWH. Telehealth in HIV care is here to stay; however, it may not yet be suitable for all PWH and all care encounters. Decision processes related to telehealth versus in-person care need to involve providers and PWH. Existing telehealth options require multilevel adjustments addressing persistent challenges.
为确保在 COVID-19 大流行期间医疗服务的连续性，远程医疗已广泛应用于人类免疫缺陷病毒（HIV）的护理中。然而，人们对远程医疗的参与度和从中受益程度并不均等。本研究旨在评估 HIV 感染者（PLHIV）和 HIV 护理提供者使用远程医疗的意愿，以及他们对远程医疗在 HIV 护理中的未来作用的看法。我们对来自南卡罗来纳州的 18 名 PLHIV 和 10 名 HIV 护理提供者进行了深入访谈，评估了他们使用远程医疗的意愿、对远程医疗在 HIV 护理未来发展的看法，以及改善远程医疗的建议。访谈采用主题分析进行分析。大多数 PLHIV 为女性（61%）、非裔美国人（67%）和非西班牙裔（78%）。大多数 PLHIV（61%）和所有提供者都曾使用远程医疗进行 HIV 护理。大多数 PLHIV 和所有提供者报告称，他们愿意在未来使用或（重新）考虑远程医疗 HIV 护理服务。提供者认为，远程医疗最适合常规 HIV 护理就诊，以及对临床稳定、总体健康的 PLHIV 进行的护理。对远程医疗的态度存在差异，大多数受访者对远程医疗的评价与面对面护理相似或更高，但仍有超过 20%的受访者认为远程医疗的价值较低。改善远程医疗的建议包括针对四个领域的多层次策略：技术、远程医疗的虚拟性质、行政流程以及 PLHIV 的社会人口统计学特征。远程医疗在 HIV 护理中的应用已经成为现实；然而，它可能还不适合所有的 PLHIV 和所有的护理情况。与面对面护理相比，关于远程医疗的决策过程需要涉及提供者和 PLHIV。现有的远程医疗方案需要进行多层次的调整，以解决持续存在的挑战。
