"I totally didn't need to be there in person": New York women's preferences for telehealth consultations for sexual and reproductive healthcare in primary care.

Background: Expanding telehealth in the United States during the COVID-19 pandemic supported patients with needed sexual and reproductive healthcare (SRH) for continuity of care and reproductive autonomy. While telehealth for SRH is feasible and acceptable, studies have not explored patient preferences towards telehealth SRH from primary care settings.

Objective: We explore New York women's preferences for telehealth SRH in primary care.

Methods: In 2021, we conducted 5 focus groups and 8 interviews with New York women of reproductive age who had a consultation with a primary care provider in the last year as part of a larger study on assessing SRH quality in primary care. We queried on experiences with telehealth for SRH and perceptions of measuring SRH quality in primary care telehealth consultations. We employed reflexive thematic analysis.

Results: We recruited 30 participants. They preferred telehealth for "basic" SRH conversations, such as contraceptive counselling, and desired in-person consultations for "complex" topics, like pregnancy and preconception, especially if nulliparous. Telehealth benefits included convenience, simplicity of some SRH needs, and alleviating power dynamics in patient-provider relationships. Challenges included lack of one-on-one connection, seriousness of pregnancy discussions, privacy, and internet access. Measuring quality of telehealth SRH should include fostering positive and engaging environments.

Conclusion: Participants find telehealth SRH in primary care preferable, underscoring the importance of offering and expanding this care. As telehealth SRH expands, providers should strengthen quality by building rapport to facilitate conversations on "serious" topics and their ability to help patients remotely.