Telehealth Usage and Impact on HIV Prevention Services Among Men Who Have Sex with Men Across the United States During 2020 Público
Williams, Tiana (Spring 2022)
Published
Abstract
Background
The temporary expansion of telehealth services during COVID-19 pandemic has addressed interruptions in the delivery of healthcare and reduced some barriers to care in the United States (US). However, young men who have sex with men (MSM) are still being marginalized and disproportionately impacted by HIV and service interruptions caused by the COVID pandemic. This study determined the overall prevalence of telehealth usage and investigate the impact of telehealth use on HIV prevention services during COVID-19 pandemic among MSM in the US.
Methods
We examined types of healthcare provider (HCP) visits among MSM who responded to the 2020 cycle of American Men’s Internet Survey (AMIS). Prevalence of telehealth usage by preventative services offered/received was assessed using log binomial regression.
Results
We found overall low rates of telehealth use (9%) in 2020. When compared to combined or in-person visits, those who used telehealth only when seeing their HCP in 2020 were more likely to be younger, Hispanic/Latino, located in Western region of the US, reside in large metro areas of with a population of 1 million+, have public insurance, and have a lower annual income (p < 0.0001, for all). Being offered HIV testing (PR: 0.95, 95% CI: 0.90, 0.99) or sexual health counseling (PR: 0.88, 95% CI: 0.79, 0.98) was less common among those who received their healthcare only by telehealth in 2020. Discussing PrEP, however, was 13% more common during telehealth visits after adjusting for confounders (PR: 1.13, 95% CI: 1.02, 1.25).
Conclusion
While telehealth was less common during 2020 in the AMIS cohort than was expected during a global pandemic, it was associated with differing access to preventive health services. Those who were seen only by telehealth were less likely to have been offered HIV testing or sexual health counseling although this difference was not seen with counseling associated with PrEP use. Those who received their healthcare in a combination of visit types in 2020 were 16-35% more likely to be offered an HIV test, discuss PrEP, or receive sexual health counseling compared to those who only saw their HCP in-person.
Table of Contents
Introduction 1
Methods 3
Study Design 3
Measures 3
Statistical Analysis 4
Results 5
Participant Characteristics 5
Log Binomial regression 6
Univariate Analysis 6
Differences in HIV Prevention Services 6
Multivariate Analysis 7
Discussion 8
Limitations 9
Conclusions 10
References 11
About this Master's Thesis
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