COVID-19, Telemedicine, and Patient Empowerment in HIV Care and Research
COVID-19, Telemedicine, and Patient Empowerment in HIV Care and Research
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DOI：
10.1007/s10461-020-02926-x
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发表时间：
2020-05-21
影响因子：
4.4
通讯作者：
Sobieszczyk, Magda E.
中科院分区：
文献类型：
--
作者：
Mgbako, Ofole;Miller, Emily H.;Sobieszczyk, Magda E.
除了悲惨的生命损失之外，2019冠状病毒病大流行还扰乱了美国各地的艾滋病毒护理服务。为了满足艾滋病毒/艾滋病感染者在整个护理过程中的需求，卫生系统扩大了远程医疗（如视频、电话就诊）的使用，以保持艾滋病毒治疗的依从性和护理参与。尽管一些有希望的早期结果[1,2]，提供者必须考虑远程医疗对患者-提供者关系的影响，以及对持续护理的信任的建立，特别是对最弱势群体。以患者的价值观和偏好为重点的方法提供了在这种艾滋病毒护理的新范例中赋予艾滋病卫生组织权力的机会。作为在纽约市工作的艾滋病毒初级保健医生和研究人员，我们在COVID-19大流行期间寻求工作连续性的同时，努力应对远程医疗的好处和挑战。在过去的十年中，远程医疗在艾滋病毒治疗中的应用有所增加[2,3]。最近对371名艾滋病毒感染者进行的一项研究发现，57%的答复者更有可能使用远程医疗进行艾滋病毒护理。该样本主要是在美国出生的，具有较高的教育水平，并感知到与艾滋病毒相关的耻辱感。远程医疗的广泛接受可能只在PLHWA的特定亚群中是真实的。鉴于COVID-19和HIV-1大流行之间存在显著的健康差异，我们认为，努力建立公平的HIV护理模式非常重要。在本文中，我们提出了一个病人的情况下，从我们的艾滋病诊所，并探讨以病人为中心的护理和远程医疗之间的潜在权衡。
Beyond the tragic loss of life, the COVID-19 pandemic has disrupted HIV care delivery throughout the US To meet the needs of people living with HIV/AIDS (PLWHA) along the care continuum, health systems have expanded the use of telemedicine (eg, video, telephone visits) to maintain HIV treatment adherence and care engagement. Despite some promising early results [1, 2], providers must consider the implications of telemedicine on the patient-provider relationship and the establishment of trust in ongoing care, particularly for the most vulnerable. An approach focused on patients’ values and preferences provides an opportunity to empower PLWHA in this new paradigm of HIV care. As HIV primary care physicians and researchers working in New York City, we have grappled with the benefits and challenges of telemedicine as we seek continuity in our work during the COVID-19 pandemic. The move toward telemedicine in HIV care has increased over the past decade [2, 3]. A recent study of 371 PLWHA found 57% of respondents were more likely to use telemedicine for their HIV care compared to in-person [4]. This sample was predominantly US-born, with a higher education level and perceived HIV-related stigma [4]. Broad acceptance of telemedicine may be true only in specific subgroups of PLHWA. Due to the notable health disparities in both the COVID-19 and HIV-1 pandemics, we believe it is important to work towards equitable models of HIV care [5]. In this paper, we present a patient case from our HIV clinic and explore the potential tradeoffs between patient-centered care and telemedicine.