Experiences Accessing Healthcare Services during COVID-19 among Persons Living with HIV (PLWH) in Western Washington

Abstract

COVID-19 social distancing has posed significant challenges to the provision of healthcare services and their accessibility, making accessing routine care difficult. In this study, we explore how COVID-19 social distancing has impacted accessing routine care services for persons living with HIV (PLWH) in Western Washington State. Twenty-four patients from the University of Washington HIV clinic patient registry were recruited to participate in semi-structured in-depth interviews (IDIs) through purposive sampling. All 24 IDIs were conducted through HIPAA-compliant Zoom, audio recorded, and transcribed. Thematic analysis was conducted to identify important themes related to how COVID-19 social distancing has impacted healthcare access among PLWH. COVID-19’s impact on healthcare access in this population varied considerably. Individuals who expressed difficulty navigating the system relied heavily on social services support, and some described negative experiences with telemedicine. Participants who were less reliant on social services often expressed that their ability to access healthcare was unchanged due to COVID-19 social distancing restrictions. These individuals described positive experiences with telemedicine and satisfaction with their HIV care. For some patients, fear of contracting COVID-19 led them to delay needed care. Others noted that fear of contracting COVID-19 increased their motivation to adhere to their HIV medications, which they perceived would protect them from COVID-19. Our results highlight disparities in COVID-19’s impact on access to healthcare services, with more vulnerable patients who required social services to help to engage in care expressing greater challenges. Despite recent innovations in healthcare delivery in response to the COVID-19 pandemic, current and future healthcare innovations should be carefully evaluated and provided along with adjunctive services if needed, in order to ensure equitable healthcare access.