Telehealth resources and utilization interest among women who sell sex: an explanatory sequential mixed methods study

Abstract

ObjectiveAmong a sample of women who sell sex (WSS), we examined unmet health needs, resources for telehealth, utilization interest, and attributes associated with interest in using telehealth. Study designExplanatory sequential mixed methods MethodsWSS (N=52) completed a fixed choice survey and focus group (N=6, 26 individuals) from drop-in centers serving WSS. Chi-square/t-tests and results from the survey data informed the semi-structured focus group interview guide. Thematic analysis of focus group data was conducted to identify themes. ResultsOver half (58%) of participants expressed interest in using telehealth; however, some lack the necessary resources for use. While 60% of participants own mobile phones and 46% have access to a computer, only 35% have a secure, private space for telehealth appointments. Interest in telehealth was higher among participants who self-identified as having high risk for HIV compared to low risk for HIV (79% versus 46%, p=0.024), and among those considering PrEP for HIV prevention versus not considering PrEP (68% versus 32%, p=0.046). Focus group participants preferred face-to-face encounters for complex medical concerns but expressed interest in telehealth for improved access to healthcare providers for routine care and mental health. ConclusionIncorporating telehealth into community organizations could be one strategy to address health inequities experienced by WSS. Access to resources, including technology and safe spaces may be well-accepted if offered at trusted community organizations. Such accessibility addresses a gap in care for WSS and paves the way for new avenues for HIV prevention, mental health support, and research related to unmet health needs among WSS.