Enhancing future HIV services through telehealth services: an observational study to explore telehealth adoption and usage for HIV prevention and treatment during the COVID-19 pandemic.

Abstract

Background Telehealth adoption for HIV care continuum accelerated during the COVID-19 pandemic. This study explored telehealth usage, motivators and barriers to telehealth adoption, and implementation challenges during the pandemic among people living with HIV, individuals at risk and community-based organisations (CBOs) in Asia. Methods This cross-sectional study was conducted in June to December 2022 using an online quantitative survey among people living with HIV (n =787) and individuals at risk (n =744), and semi-structured qualitative interviews with CBOs across nine countries/territories in Asia. Responses from the survey were reported descriptively, and narratives from the interviews were used to identify the main themes associated with engagement configurations by CBOs. Results Regionally, HIV-related telehealth services were used by 56.8% of people living with HIV and 66.5% of individuals at risk, with 53.6-55.9% increasing their usage in 2021. Phone consultations, HIV-related health information sharing and video communications were the most commonly accessed services by telehealth users. Telehealth users most trusted mobile applications or software provided by clinics/healthcare providers/local CBOs. Telehealth uptake motivators included saving travelling time, improved access to HIV prevention care services and information outside of medical appointments; barriers included data privacy concerns and lack of technology accessibility, which were similarly acknowledged by local CBOs. Lack of resources to support telehealth services, and local policies on HIV prevention and treatment impeded CBOs from adequately delivering HIV care through telehealth. Conclusions This study highlights the potential of telehealth in HIV care while identifying critical challenges for its sustained integration. Addressing these issues (e.g. data privacy, telehealth infrastructure) would be essential to optimise telehealth services and improve HIV outcomes in the region.