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IDWeek 2022 has featured a collection of posters covering a range of topics on infectious diseases—from COVID-19 to tuberculosis. What did we learn about HIV?

Telehealth and HIV Care During the COVID-19 Pandemic

Telemedicine became a powerful and necessary tool during the COVID-19 pandemic, but such care required a smartphone or tablet, the right app, and a bit of technological know-how to connect patients to their healthcare providers. Are such barriers large enough to prevent a patient from getting the telemedicine care they need? At the 2022 IDWeek, Dr. Smitha Gudipati of the Henry Ford Health System presented a poster highlighting the MyChart initiative, a recent assessment of PLWH who were given the opportunity to use the MyChart telemedicine software. The study identified the reasons why some patients avoided the service.

The assessment from October 2020 to May 2021 looked at 209 PLWH who had not used telehealth services. These patients, enrolled in the Ryan White Program in the Infectious Disease Clinic at Henry Ford Hospital, signed up for the MyChart initiative. Participants were guided through the process of installing and using the app. If needed, patients were given phones pre-loaded with the app. 

Demographic data were collected, and patients who signed up but didn’t use the app were asked what was stopping them from accessing telemedicine.  The most popular reason for not using the service was a lack of technology and information, and some didn’t prioritize installing the app. According to the study, the reasons for not using MyChart were:

• Information unavailable: 29 percent
• Education needed: 27 percent
• “Hasn’t gotten around to it”: 18 percent
• Password help: 10 percent
• Limited resources: 9 percent
• Technical issues: 6 percent
• Distrust in technology: 1 percent

While MyChart was available to every PLWH in the RW program, over half didn’t have a compatible device or needed help to download and use the app. And older patients were more likely to need help getting everything set up. Based on these findings, the presenter recommends more work is needed to help promote telemedicine and ensure the tool is being properly used across all demographics.

Assessing HIV Prevention Knowledge and HIV Stigma in an Urban Midwestern Community

One of the primary barriers to HIV prevention, diagnosis, and treatment remains stigma and discrimination. While several studies have explored HIV stigma as perceived by individuals with HIV and stigma among HIV care providers, one study, presented at IDWeek 2022, assessed the knowledge of HIV prevention, the prevalence of misconceptions about HIV, and HIV-related stigma within an urban midwestern community.

Presented by Adrianna Uhlar, a medical student at the Case Western Reserve University School of Medicine in Cleveland, Ohio, Ms. Uhlar and her co-authors surveyed community members at three STI clinics and employees at a community organization and the safety-net hospital in Cleveland, Ohio. Participants were asked questions about their demographics, their sexual behavior, HIV prevention, and HIV stigma.

Of the 262 community members surveyed

• 19 percent were 24 years old or younger
• 51.5 percent were male
• 85.2 percent identified as Black
• 45.6 percent completed high school

And of the 137 employees surveyed

• 4 percent were 24 years old or younger
• 21.2 percent were male
• 15.6 percent identified as Black
• 43.1 percent graduated college/university

The results of the study divided data into two separate categories: assessing knowledge of HIV, and assessing HIV-associated stigma, and found the following:

• 59 percent of employees answered correctly when asked if people with HIV on medications are less likely to infect others, as opposed to 38.7 percent of community members
• 26 percent of community members incorrectly answered when asked if HIV was a manmade virus, as opposed to the 5.3 percent of employees who answered that incorrectly
• 42.5 percent of community members answered incorrectly when asked if there was a known cure for HIV/AIDS, as opposed to the 18.7 percent of employees who answered incorrectly

The study also found that many of the community members and employees find the people around them talk badly about people living with HIV, and wouldn’t want their co-workers to know if they had HIV.

Based on these results, the study’s authors concluded that while internal stigma around HIV remains low, external stigma is still high. And that suspicion that HIV is a manmade virus and that a cure existed, but was being withheld from the community, was prevalent among community members. But further research is needed to help better understand why this external stigma persists and why these suspicions exist.