Carnes Neal, Koenig Linda J, Wilkes Aisha L, Gelaude Deborah, Salabarría-Peña Yamir, Johnston Marie
Division of HIV Prevention, STD and TB Prevention, Centers for Disease Control and Prevention, National Center for HIV, Viral Hepatitis, Atlanta, GA, USA.
Office of Science, National Center for Injury Prevention and Control, CDC, Atlanta, GA, USA.
J Racial Ethn Health Disparities. 2025 Mar 3. doi: 10.1007/s40615-025-02319-7.
We conducted a demonstration project of telemedicine HIV care services at the University of Florida (UF) College of Medicine, Jacksonville. Our sample focused on members of racial and ethnic minority groups living in an urban setting. As part of the project's evaluation, we conducted 13 focus groups. Focus groups assessed patient, staff, and provider experiences with facilitating or hindering factors to engaging in telemedicine. We also explored the decision-making processes among people with HIV (PWH) to engage or not in telemedicine. The 46 focus group participants included 21 PWH: 12 PWH who accepted and nine who declined participation in telemedicine. The remaining 25 focus group participants were comprised of medical, clinical support, and community-based organization staff who supported the demonstration project. An unexpected finding that emerged in the focus group narratives detailed that some PWH who accepted telemedicine visits appreciated that telemedicine minimized the stigma they have experienced during in-person healthcare encounters. Among PWH who declined a telemedicine visit, they felt the extension of service into their personal world invaded their privacy, created routes for stigma should their HIV status be disclosed outside the healthcare setting, and raised concerns about confidentiality in virtual settings. Like the PWH, the professionals were mixed in their opinions in that some felt telemedicine facilitated care while others raised concerns. Findings point to the importance of allowing PWH to select the format (in-person or via telemedicine) in which their HIV care is rendered and highlight the importance of intervening to decrease healthcare facility-based stigma.
我们在佛罗里达大学杰克逊维尔医学院开展了一项远程医疗艾滋病护理服务示范项目。我们的样本聚焦于居住在城市环境中的少数族裔群体成员。作为项目评估的一部分，我们进行了13次焦点小组讨论。焦点小组评估了患者、工作人员和提供者在远程医疗参与过程中的促进或阻碍因素方面的体验。我们还探讨了艾滋病病毒感染者（PWH）参与或不参与远程医疗的决策过程。46名焦点小组参与者包括21名艾滋病病毒感染者：12名接受并9名拒绝参与远程医疗的艾滋病病毒感染者。其余25名焦点小组参与者由支持该示范项目的医疗、临床支持和社区组织工作人员组成。焦点小组讨论记录中出现的一个意外发现详细表明，一些接受远程医疗就诊的艾滋病病毒感染者赞赏远程医疗将他们在面对面医疗接触中所经历的耻辱感降至最低。在拒绝远程医疗就诊的艾滋病病毒感染者中，他们觉得服务延伸到他们的个人世界侵犯了他们的隐私，如果他们的艾滋病病毒感染状况在医疗环境之外被披露，会产生耻辱的途径，并引发了对虚拟环境中保密性的担忧。与艾滋病病毒感染者一样，专业人员的意见也各不相同，一些人认为远程医疗便利了护理，而另一些人则提出了担忧。研究结果指出，让艾滋病病毒感染者选择提供其艾滋病护理的形式（面对面或通过远程医疗）很重要，并强调了进行干预以减少医疗机构内耻辱感的重要性。
