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. 2024 Sep;28(9):2875-2886.
doi: 10.1007/s10461-024-04366-3. Epub 2024 Jun 10.

Telehealth Models for PrEP Delivery: A Systematic Review of Acceptability, Implementation, and Impact on the PrEP Care Continuum in the United States

Stephen Bonett  1 , Qian Li  2 , Anna Sweeney  2 , Denise Gaither-Hardy  3 , Hussein Safa  4
Affiliations

Telehealth Models for PrEP Delivery: A Systematic Review of Acceptability, Implementation, and Impact on the PrEP Care Continuum in the United States

Stephen Bonett et al. AIDS Behav. 2024 Sep.

Abstract
in English, German

Pre-exposure prophylaxis (PrEP) is pivotal in curbing HIV transmission and is integral to the national plan to end the HIV epidemic in the United States (US). Nonetheless, widespread PrEP adoption faces barriers. Telehealth delivery models for PrEP, or telePrEP, can enhance PrEP access and adherence by providing flexible care remotely. This study presents a systematic review of telePrEP programs in the US, aiming to describe model characteristics and summarize clinical, implementation, and equity outcomes. We reviewed studies published from 2012 to 2023. We included articles that described telePrEP systems in the US and measured PrEP care continuum outcomes (awareness, initiation, uptake, adherence) or acceptability of the intervention by program users. Eight articles describing six distinct telePrEP initiatives met our inclusion criteria. Studies described models implemented in community-based, academic, and commercial settings, with most programs using a direct-to-client telePrEP model. Across studies, clients reported high acceptability of the telePrEP programs, finding them easy to use, convenient, and helpful as a tool for accessing HIV prevention services. No programs were offering injectable PrEP at the time these studies were conducted. Data was limited in measuring PrEP retention rates and the reach of services to underserved populations, including Black and Latinx communities, transgender individuals, and cis-gender women. Findings underscore the potential of telePrEP to bolster the reach of PrEP care and address structural barriers to access. As telehealth models for PrEP care gain prominence, future research should concentrate on refining implementation strategies, enhancing equity outcomes, and expanding services to include injectable PrEP.

La profilaxis preexposición (PrEP) es fundamental para frenar la transmisión del VIH y es parte integral del plan nacional para acabar con la epidemia del VIH en los Estados Unidos (EE. UU.). Sin embargo, la adopción generalizada de la PrEP enfrenta barreras. Los modelos de entrega de PrEP a través de la telesalud (telePrEP) pueden mejorar el acceso y la adherencia a la PrEP al proporcionar atención medica flexible de forma remota. Este estudio presenta una revisión sistemática de la literatura sobre los programas de telePrEP en los EE. UU., con el objetivo de describir las características del modelo y resumir los resultados clínicos, resultados de implementación y resultados de equidad. Revisamos estudios publicados entre 2012 y 2023. Incluimos artículos que describían sistemas de telePrEP en los EE. UU. y medían los resultados del continuo de atención de la PrEP (conciencia, iniciación, adopción, adherencia) o la aceptabilidad de la intervención por parte de los usuarios del programa. Los ocho artículos que describen las seis iniciativas distintas de telePrEP cumplieron nuestros criterios de inclusión. Los estudios describieron modelos implementados en entornos comunitarios, académicos y comerciales, y la mayoría de los programas utilizaron un modelo de telePrEP dirigido directamente al cliente. En todos los estudios, los clientes reportaron una alta aceptabilidad hacia los programas de telePrEP, encontrándolos fáciles de usar, convenientes y útiles como herramienta para acceder a los servicios de prevención del VIH. Ningún programa ofrecía PrEP inyectable en el momento en que se realizaron estos estudios. Los datos fueron limitados para medir las tasas de retención de la PrEP y el alcance de los servicios a las poblaciones desatendidas, incluyendo las comunidades Negras y Latines, las personas transgénero y las mujeres cisgénero. Los hallazgos subrayan el potencial de la telePrEP para reforzar el alcance de la atención de la PrEP y abordar las barreras estructurales de acceso. A medida que los modelos de telesalud para la atención de la PrEP ganan protagonismo, las investigaciones futuras deberan concentrarse en refinar las estrategias de implementación, mejorar los resultados de equidad y expandir los servicios para incluir la PrEP inye`ctable.

Keywords: Access to care; HIV Prevention; Health Equity; Pre-exposure Prophylaxis; Telehealth.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1
Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) diagram for the articles reviewed [55]
See this image and copyright information in PMC

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References

    1. Fauci AS, Redfield RR, Sigounas G, Weahkee MD, Giroir BP. Ending the HIV epidemic: a plan for the United States. JAMA: J Am Med Association. 2019;321:844–5. - PubMed
    1. Mayer KH, Agwu A, Malebranche D. Barriers to the wider use of pre-exposure Prophylaxis in the United States: a narrative review. Adv Therapy. 2020;37:1778–811. - PMC - PubMed
    1. Laborde ND, Kinley PM, Spinelli M, Vittinghoff E, Whitacre R, Scott HM, et al. Understanding PrEP persistence: provider and patient perspectives. AIDS Behav. 2020;24:2509–19. - PMC - PubMed
    1. Ogunbajo A, Storholm ED, Ober AJ, Bogart LM, Reback CJ, Flynn R, et al. Multilevel barriers to HIV PrEP uptake and adherence among black and Hispanic/Latinx transgender women in southern California. AIDS Behav. 2021;25:2301–15. - PMC - PubMed
    1. Nydegger LA, Dickson-Gomez J, Ko TK. Structural and syndemic barriers to PrEP adoption among black women at high risk for HIV: a qualitative exploration. Cult Health Sex. 2021;23:659–73. - PMC - PubMed

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