Social Determinants of Potential eHealth Engagement Among People Living with HIV Receiving Ryan White Case Management: Health Equity Implications from Project TECH

• Published in: AIDS and behavior Vol. 24; no. 5; pp. 1463 - 1475
• Main Authors: Marhefka, Stephanie L., Lockhart, Elizabeth, Turner, DeAnne, Wang, Wei, Dolcini, M. Margaret, Baldwin, Julie A., Roig-Romero, Regina Maria, Lescano, Celia M., Glueckauf, Robert L.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.05.2020; Springer Nature B.V
• Subjects: Black white relations; Case management; Cellular telephones; Fairness; Health care delivery; Health disparities; Health education; Health Psychology; Health services; HIV; Human immunodeficiency virus; Inequality; Infectious Diseases; Medicine; Medicine & Public Health; Original Paper; Public Health; Regression analysis; Regression models; Short message service; Technology; Technology Acceptance Model; Text messaging; Florida; United States > US; mHealth; Health equity; Delivery of health care; HIV; eHealth
• ISSN: 1090-7165; 1573-3254
• DOI: 10.1007/s10461-019-02723-1

Objectives Evaluate the relationships between social characteristics of Floridian persons living with HIV (PLWH) and both use of digital technologies and willingness to use eHealth for HIV-related information. Methods Ryan White case managers (N = 155) from 55 agencies in 47 Florida counties administered a survey to PLWH (N = 1268) from June 2016-April 2017. Multilevel logistic regression models were used to identify correlates of technology use and willingness. Results Use of mobile phones with text messaging was high (89%). Older (vs. younger) adults and non-Hispanic blacks (vs. whites) were less likely to use most technologies. These groups, along with Hispanics (vs. whites) were less likely to express willingness to use technologies for HIV-related information in models adjusting for use. Conclusions Among PLWH in Florida, eHealth-related inequities exist. Willingness to engage in HIV-related eHealth is affected by social determinants, even when considering technology access. Although eHealth may reduce some healthcare inequities, it may exacerbate others.