Walker Daisy, Moucheraud Corrina, Butler Derrick, Takayama Christian, Shoptaw Steven, Currier Judith S, Gladstein Jay, Hoffman Risa
Division of Infectious Diseases, David Geffen School of Medicine at UCLA, Los Angeles, CA, US.
School of Global Public Health, New York University, New York, NY, US.
BMC Infect Dis. 2024 Dec 31;24(1):1481. doi: 10.1186/s12879-024-10351-x.
The COVID-19 pandemic resulted in the rapid implementation of telemedicine for HIV care at federally qualified health centers (FQHCs) in the United States. We sought to understand use of telemedicine (telephone and video) at two FQHCs in Los Angeles, and the client attitudes towards and experiences with telemedicine as part of future HIV care.
We conducted surveys with 271 people living with HIV (PLHIV), with questions covering sociodemographic factors, telemedicine attitudes and experiences, technological literacy, and access to technological resources and privacy. Survey data were analyzed utilizing summary statistics, chi-square analyses, and Fisher's exact test to understand associations between sociodemographic factors and telemedicine attitudes and experiences.
Sixty percent of the sample had used any telemedicine and, of these, 93% utilized only telephone visits. Almost all respondents (95%, n = 257) had access to a functioning smartphone and self-rated their technological literacy as high. Most had consistent access to privacy (88%, n = 239), and those without privacy noted this as a barrier to the use of telemedicine. The main benefits of telemedicine (compared to in person) were savings of time and money, convenience, and ability to complete appointments as scheduled. Just over half of PLHIV said they would feel more comfortable discussing sensitive topics (e.g., substance use, relationship issues) in person than over telephone (60%, n = 164) or video (55%, n = 151). Despite limited experience with video telemedicine, half of all participants desired a mix of telephone and video visits as part of their future HIV care.
During a mature phase of the COVID-19 pandemic, PLHIV in our study showed high satisfaction with telemedicine, largely conducted as telephone visits, and high interest in telemedicine visits as a component of their future HIV care. Future studies should explore barriers to implementing video telemedicine in FQHCs and determine telemedicine's impact on clinical outcomes, including engagement and viral suppression.
新冠疫情导致美国联邦合格医疗中心（FQHCs）迅速实施远程医疗服务以提供艾滋病毒护理。我们试图了解洛杉矶两家FQHCs的远程医疗（电话和视频）使用情况，以及客户对远程医疗作为未来艾滋病毒护理一部分的态度和体验。
我们对271名艾滋病毒感染者（PLHIV）进行了调查，问题涵盖社会人口学因素、远程医疗态度和体验、技术素养以及技术资源获取和隐私情况。利用汇总统计、卡方分析和费舍尔精确检验对调查数据进行分析，以了解社会人口学因素与远程医疗态度和体验之间的关联。
60%的样本使用过任何形式的远程医疗，其中93%仅使用电话问诊。几乎所有受访者（95%，n = 257）都能使用正常运行的智能手机，并自评其技术素养较高。大多数人能持续获得隐私保护（88%，n = 239），而那些没有隐私保护的人指出这是使用远程医疗的障碍。远程医疗（与面对面就诊相比）的主要好处是节省时间和金钱、方便，以及能够按计划完成预约。略超过一半的艾滋病毒感染者表示，他们觉得当面讨论敏感话题（如药物使用、关系问题）比通过电话（60%，n = 164）或视频（55%，n = 151）更自在。尽管视频远程医疗经验有限，但所有参与者中有一半希望在未来的艾滋病毒护理中采用电话和视频问诊相结合的方式。
在新冠疫情的成熟阶段，我们研究中的艾滋病毒感染者对主要以电话问诊形式开展的远程医疗高度满意，并对远程医疗问诊作为未来艾滋病毒护理的一部分表现出浓厚兴趣。未来的研究应探索在FQHCs实施视频远程医疗的障碍，并确定远程医疗对临床结果的影响，包括参与度和病毒抑制情况。
