An Assessment of Telehealth Utility and Attitudes in Infectious Disease Patients

Background: Persons living with HIV (PWH) experience numerous barriers to care and require routine follow-up, lab testing, and preventative care to maintain their health. Since 2020, telehealth has been widely and rapidly implemented across all health fields, changing the delivery of care. Preliminary data show that PWH experienced increases in their viral load counts and decreases in appointment frequency during 2020. There are limited studies on the current telehealth practices of PWH. This study aims to investigate the effect of current telehealth usage, attitudes, and accessibility on short-term health outcomes among patients attending a diverse infectious disease clinic. Method: A 45-question cross-sectional qualitative survey study was open to patients attending in-person appointments at MedStar Georgetown University Hospital Infectious Disease outpatient clinic from August 2022 to August 2023. All adult, nonpregnant, nonincarcerated patients with at least 1 appointment at the infectious disease clinic were eligible to participate. Results: Of the 129 surveyed patients, 96.9% (n = 126) had access to an internet-capable device, and 57% (n = 74) had at least 1 telehealth appointment within 6 months of survey completion. 40.3% (n = 52) of patients had appointments relating to the treatment and prevention of HIV. Among surveyed patients, all telehealth modalities were favorably viewed; however, both asynchronous telehealth and synchronous video were significantly preferred to audio-only services (mean: 3.86, 3.79, 3.38, respectively, p < 0.01). Younger patients (<60 years old) rated asynchronous telehealth modalities significantly higher than their 60+ counterparts (p < 0.05). Self-identified Black participants were significantly more likely to prefer audio-only telehealth services compared to non-Black patients (mean: 3.76 vs. 3.18, p < 0.05). Discussion: There have been limited studies investigating the continued use of telehealth services following the widespread uptake of Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination in 2021 in terms of accessibility and patient attitudes. This study supports that telehealth services are still used and favored by surveyed patients. When stratified by race, Black individuals were significantly more likely to prefer audio-only calls, which was inconsistent with the overall favorable view of video visits by the surveyed population at large. The ideal modality of virtual health care needs further exploration.