"It's a lifeline": perspectives and experiences of health technology use among HIV care providers in rural Florida

Clinical Snapshot

Key Findings

• P Value: Not applicable — qualitative study

• Effect Size: Not applicable — qualitative study; no quantitative effect sizes reported

• Primary Outcome: Four thematic domains identified from provider interviews: (1) current and prior health technology practices — rapid expansion since COVID-19 onset, especially video calls, with preference for multiple communication modalities; (2) drawbacks — lack of human connection, increased provider and patient burden, confidentiality concerns, technology malfunction, discomfort with technology, and financing constraints; (3) benefits — improved communication and access to care, social connection and community support, reduced HIV-related stigma; (4) potential facilitators — user-friendly design and economic incentives

• Nnt Or Sensitivity: Not applicable — qualitative study; transferability of findings is the relevant analogue, which is partially supported by the structured thematic framework and multi-site rural Florida context

• Confidence Interval: Not applicable — qualitative study

Clinical Application

Implementation of health technology in rural HIV care is feasible but requires targeted investment in: digital infrastructure (broadband access), provider and patient digital literacy training, user-friendly platform design, sustainable financing models (e.g., telehealth reimbursement parity), and confidentiality-preserving protocols. The COVID-19 pandemic has demonstrated that rapid adoption is possible when systemic barriers are temporarily reduced. This study has direct relevance to Australian rural and remote HIV care, where geographic isolation, workforce shortages, and HIV-related stigma create analogous barriers to care engagement. The RACGP supports telehealth as a key strategy for rural health equity, and the Australian Government's permanent telehealth MBS items (introduced post-COVID-19) address some of the financing constraints identified in this study. The TGA does not regulate telehealth platforms per se, but the Australian Digital Health Agency's My Health Record and national telehealth frameworks provide relevant governance infrastructure. Aboriginal and Torres Strait Islander communities in remote Australia — who face disproportionate HIV burden in some regions — represent a population for whom the benefits and drawbacks identified in this study (particularly confidentiality concerns and reduced stigma) are especially pertinent. Australian HIV care providers and s100 prescribers in rural settings may find the facilitator and barrier framework directly applicable to local implementation planning. HIV care providers (physicians, nurses, nurse practitioners, social workers, case managers) working in rural or geographically isolated settings with limited specialist access; findings are most directly applicable to providers in the rural American South but have relevance to any resource-limited, high-stigma HIV care environment

Abstract

The use of health technology, such as telehealth and mobile health used to support or deliver health care, is a promising strategy to improve HIV outcomes among people with HIV (PWH) in the rural South. In-depth interviews were conducted with 21 HIV care providers in rural Florida to understand the perspectives and experiences of using health technology to deliver care for PWH. Thematic analysis was applied. Emerging themes were organized under four domains: current and prior health technology practices, drawbacks to health technology, benefits of health technology, and potential facilitators of health technology. Providers revealed that health technology use has expanded rapidly since onset of the COVID-19 pandemic, especially use of video calls, but they preferred multiple communication methods. Drawbacks to health technology included lack of human connection, increased burden to providers and patients, confidentiality concerns, technology malfunctioning, discomfort with technology, and financing constraints. Benefits included improved communication and access to care, social connection and community support, and reduced HIV-related stigma. Potential facilitators included health technology that is user-friendly, and economic incentives to increase technology use. Health technology holds promise for addressing barriers to HIV care, however, its drawbacks must be addressed to ensure effective implementation in the rural South.

References

1. 1.Gracy, A., Woody, A., Ingersoll, K., Dillingham, R., Cook, R. L., Watt, M. H., & Manavalan, P. (2026). "It's a lifeline": perspectives and experiences of health technology use among HIV care providers in rural Florida. AIDS Care. https://doi.org/10.1007/s10461-021-03349-y