Telemedicine acceptability and experience in a marginalized population at high-risk for hcv

Background: Telemedicine offers the opportunity to provide clinical services at a distance, thereby bridging geographic and other barriers to medical care. With the need to socially distance during the COVID-19 pandemic, clinical practices rapidly transitioned to telemedicine across the United States. Telemedicine will remain an important component of healthcare delivery but if not utilized in an equitable manner could exacerbate health disparities. To understand usage among medically underserved communities, we investigated acceptability and experiences with telemedicine among people undergoing community-based HCV screening as part of a larger ongoing point-of-diagnosis HCV treatment study (NOW Study). Methods: We performed descriptive and comparative analysis of self-report data about sociodemographic, clinical history, mobile device and internet access, and telemedicine experience and satisfaction information collected at the time of HCV screening between December 2020 and May 2021. Results: Among 92 participants (median age 42 years;75% men;50% non-White;73% with recent injection drug use);55% had reactive HCV antibody and 35% had active HCV. Most (86%) recently used a smartphone, tablet (44%), or laptop (37%) to access the internet (table 1). Many accessed the internet via their cellular network (70%) or relied on public or personal wireless (26%). The majority (74%) were somewhat or very interested in a telemedicine visit. Thirty (33%) had participated in a telemedicine visit (36% video, 33% telephone, 30% both);some (26%) participated prior to the COVID-19 pandemic and all had a visit during the pandemic. All but one participant (97%) described their telemedicine visit as somewhat or extremely helpful, easy (73%), and convenient (67%). Interest for future telemedicine care was higher among those with past experience compared to no experience (93% vs 65%, p=0.003;table 1). Despite general interest in telemedicine, 69% preferred in-person clinic visits when possible. No statistically significant differences emerged in age, race/ethnicity, gender, and HCV status when comparing 1) interested vs. not interested and 2) with vs. without a prior telemedicine visit. Conclusion: Within our population at high-risk for HCV, digital access was high, many had a previous telemedicine experience they found satisfying, and generally high interest in future telemedicine care. Nonetheless, when given the choice, the majority preferred in-person care.