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. 2024 Oct 19;24:306. doi: 10.1186/s12911-024-02718-6

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© The Author(s) 2024

Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.

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Fig. 1 — Building digital trust among people who use drugs (PWUD). We identified extensive use of the internet for healthcare purposes within a PWUD population with internet access (Theme 1). Despite limited experience with telehealth among FGD participants, they frequently used the internet for accessing healthcare information, scheduling appointments with healthcare providers, and obtaining medication prescriptions. Most participants perceived telehealth benefits, such as convenience, its time-saving nature, and the ease of establishing trust with healthcare providers (Theme 2). Participants agreed that these benefits outweigh telehealth’s perceived limitations, such as the inability to conduct physical examinations. However, some participants recognized that the inability to conduct physical examinations through telehealth results in reduced diagnostic accuracy compared to in-person assessments. These concerns led some participants to categorically oppose using telehealth. Participants also perceived major barriers to telehealth engagement, such as prioritization of addiction issues over healthcare, limited accessibility to technological infrastructure, and low digital literacy. Despite the reported perceived challenges, PWUD expressed a strong willingness to embrace telehealth as a healthcare delivery method and provided several suggestions to enable its widespread adoption within their communities. Participants’ suggestions included recommending an initial in-person visit before transitioning to telehealth, emphasizing the maintenance of eye contact during telehealth sessions to promote digital trust, and requesting education on how to effectively utilize telehealth services (Theme 3). Participants also believed that addressing technology accessibility limitations could be achieved through partnerships with community organizations that provide telehealth-related infrastructure, supported by physicians and the government. The identified themes support telehealth’s potential as an innovative solution to expand healthcare access for PWUD