%0 Journal Article
%@ 1438-8871
%I JMIR Publications
%V 27
%N 
%P e60369
%T Telemedicine Use During the COVID-19 Pandemic in 8 Countries From the International Sexual Health and Reproductive Health Consortium: Web-Based Cross-Sectional Survey Study
%A Tan,Rayner Kay Jin
%A Hensel,Devon
%A Ivanova,Olena
%A Bravo,Raquel Gomez
%A Olumide,Adesola
%A Adebayo,Emmanuel
%A Cleeve,Amanda
%A Gesselman,Amanda
%A Shah,Sonam Jyoti
%A Adesoba,Helen
%A Marley,Gifty
%A Tang,Weiming
%+ Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, #10-01 MD1, Singapore, 117549, Singapore, 65 91878576, rayner.tan@nus.edu.sg
%K COVID-19
%K telemedicine
%K sexual and reproductive health
%K pandemic
%K web-based survey
%K sexual health
%K reproductive health
%K communication technology
%K medical education
%K contraception
%K abortion
%K health care delivery
%K care
%K chronic condition
%D 2025
%7 4.3.2025
%9 Original Paper
%J J Med Internet Res
%G English
%X Background: Telemedicine is an important way to fill in the access gap to in-person health care services during challenging times like pandemics. Objective: This study aimed to investigate the role that telemedicine played during the COVID-19 pandemic by multicountry comparison of the use of telemedicine prior to and during the pandemic. Methods: This study analyzes data from the second wave of the International Sexual Health and Reproductive Health study. This included data collected between April 2021 and July 2022 in 8 countries, including Armenia (n=296), Egypt (n=889), Germany (n=138), Moldova (n=311), Nigeria (n=205), Portugal (n=951), Singapore (n=13), and Spain (n=54). This study covered sociodemographics, sexual and reproductive health (SRH), and telemedicine use. Descriptive statistics and multilevel modeling were used to assess the factors influencing the use of telemedicine. Results: Overall, 2857 participants were recruited. Approximately 57.6% (n=1646) of participants had never used telemedicine prior to COVID-19 measures, while 45.9% (n=1311) of participants required health care but reported not using telemedicine services following the introduction of COVID-19 measures. In high-income countries, the most common mode reported was audio-based telemedicine services, with 283 (71.8%) and 417 (73.5%) participants doing so before and during COVID-19, respectively. This was followed by text-based telemedicine services, with 152 (38.6%) and 173 (30.5%) participants doing so before and during COVID-19, respectively. In low- to middle-income countries, many participants also reported using audio-based telemedicine services, with 288 (35.3%) and 237 (40.8%) participants doing so before and during COVID-19, respectively. This was followed by chat-based telemedicine services, with 265 (32.4%) and 217 (37.3%) participants doing so before and during COVID-19, respectively. Multilevel modeling revealed that those who were older (adjusted odds ratio [aOR] 0.99, 95% CI 0.99-1.00) and were in countries with a higher gross domestic product per capita (aOR 0.99, 95% CI 0.98-1.00) were less likely to have ever used telemedicine. Participants who were of male sex assigned at birth (aOR 0.79, 95% CI 0.65-0.96) were less likely to use telemedicine during the pandemic. Participants who perceived that they were worse off financially were more likely to have switched to telemedicine during COVID-19 (aOR 1.39, 95% CI 1.02-1.89) and were more likely to report having a poor or fair experience of telemedicine services (aOR 1.75, 95% CI 1.34-2.29). When sexual orientation was included in the model, nonheterosexual individuals were more likely to ever use telemedicine prior to COVID-19 (aOR 1.35, 95% CI 1.08-1.69), more likely to have used telemedicine during COVID-19 (aOR 1.58, 95% CI 1.24-2.02), and more likely to have switched to telemedicine during COVID-19 (aOR 1.55, 95% CI 1.09-2.21). Conclusions: Telemedicine played a key role in addressing health care needs during the COVID-19 pandemic. Age, sex, economic status, and sexual orientation influenced its use. 
%M 40053813
%R 10.2196/60369
%U https://www.jmir.org/2025/1/e60369
%U https://doi.org/10.2196/60369
%U http://www.ncbi.nlm.nih.gov/pubmed/40053813