Exploring patients’ and healthcare providers’ knowledge and perceptions of benefits, challenges, and resource requirements in integrating telemedicine services into routine HIV care in western Kenya

Telemedicine offers a patient-centered approach to chronic care, including HIV. However, its uptake depends on the users' perceptions of its benefits and challenges. We explored patients' and providers' knowledge, perceptions, benefits, challenges, and resource needs for integrating telemedicine into routine HIV care. We conducted a qualitative study involving eight gender-stratified focus group discussions and 23 key informant interviews with people with HIV (PWH) and their healthcare providers (HCPs) recruited from four government facilities. Transcripts were coded and analyzed using framework analysis. The themes identified in the study included knowledge of telemedicine, perceived benefits and challenges, and implementation requirements. PWH and HCPs viewed telemedicine as enhancing access, reducing clinic congestion, and lowering travel and opportunity costs. Other benefits include improved retention, reduced stigma, and decreased provider workloads. However, they identified challenges, such as limited physical examinations, privacy concerns, and the need for user training. To implement the telemedicine intervention, they identified key resource needs such as reliable technology, electricity, internet, and confidentiality training. Rethinking scheduling workflows to adequately cater for tele-visits of patients is critical for success. Telemedicine is a viable, patient-centered addition to in-person HIV care. Addressing technological, privacy, and infrastructure barriers is essential for effective integration in resource-limited settings.