Mixed Methods Analysis of Telehealth Experience, Satisfaction, and Quality of Care During the COVID Pandemic Among Persons with HIV in Washington, DC

Authors

Shannon K. Barth, Department of Epidemiology, The George Washington University Milken Institute School of Public Health, 950 New Hampshire Avenue NW, Suite 500, Washington, DC, 20052, USA. sboyer@gwu.edu.
Kacie J. Saulters, Department of Internal Medicine, University of Maryland Capital Region Health, Largo, MD, USA.
Gayle P. Balba, Division of Infectious Diseases, Georgetown University Medical Center, Washington, DC, USA.
Anne K. Monroe, Department of Epidemiology, The George Washington University Milken Institute School of Public Health, 950 New Hampshire Avenue NW, Suite 500, Washington, DC, 20052, USA.
Michael A. Horberg, Kaiser Permanente Mid-Atlantic Permanente Research Institute, Rockville, MD, USA.
Princy N. Kumar, Georgetown University School of Medicine, Washington, DC, USA.
Alan E. Greenberg, Department of Epidemiology, The George Washington University Milken Institute School of Public Health, 950 New Hampshire Avenue NW, Suite 500, Washington, DC, 20052, USA.
Amanda D. Castel, Department of Epidemiology, The George Washington University Milken Institute School of Public Health, 950 New Hampshire Avenue NW, Suite 500, Washington, DC, 20052, USA.

Document Type

Journal Article

Publication Date

10-24-2023

Journal

AIDS and behavior

DOI

10.1007/s10461-023-04198-7

Keywords

COVID-19; HIV/AIDS; Telehealth and medicine

Abstract

The purpose of this study is to describe telehealth experiences and quality of HIV care provided to an urban population of people with HIV (PWH) in Washington, DC. We used self-reported survey data from a cohort of PWH in the DC Cohort longitudinal study linked to medical records (October 26, 2020-December 31, 2021). Analyses followed a mixed-methods approach, including prevalence estimates and multivariable logistic regression of telehealth use by demographic and HIV characteristics. We measured primary motivation, modes of engagement, and telehealth satisfaction. Qualitative responses to open-ended questions were coded using collaborative coding. A framework developed by the National Quality Forum (NQF) was applied to the results. Among 978 participants, 69% reported using telehealth for HIV care during the pandemic. High school graduates were less likely to use telehealth compared to those with college education (aOR 0.69, 95% CI 0.48, 0.98). PWH with > 1 co-morbid condition were more likely to use telehealth compared to those without (aOR 1.42, 95% CI 1.02, 1.95). The majority reported satisfaction with telehealth (81%). Qualitative analysis of telehealth satisfaction found that most responses were related to access to care and technology, effectiveness, and patient experience. PWH using telehealth during the pandemic were satisfied with their experience though use differed demographically. Telehealth was used effectively to overcome barriers to care engagement, including transportation, costs, and time. As we transition away from the emergency pandemic responses, it will be important to determine how this technology can be used in the future in an equitable manner to further strengthen HIV care engagement.

APA Citation

Barth, Shannon K.; Saulters, Kacie J.; Balba, Gayle P.; Monroe, Anne K.; Horberg, Michael A.; Kumar, Princy N.; Greenberg, Alan E.; and Castel, Amanda D., "Mixed Methods Analysis of Telehealth Experience, Satisfaction, and Quality of Care During the COVID Pandemic Among Persons with HIV in Washington, DC" (2023). GW Authored Works. Paper 3557.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/3557

Department

Epidemiology