Bringing Iowa TelePrEP to Scale: A Qualitative Evaluation

Area of Science:

• Public Health
• Telemedicine
• HIV Prevention

Background:

• Regional telehealth partnerships can improve access to HIV pre-exposure prophylaxis (PrEP).
• Best practices for these partnerships are not well-established.
• The Iowa TelePrEP model expanded statewide from 2017-2019.

Purpose of the Study:

• To evaluate the barriers and facilitators of statewide expansion for a public health-partnered telehealth model.
• To identify lessons learned from the Iowa TelePrEP expansion.

Main Methods:

• Qualitative evaluation using focus groups and interviews with public health partners.
• Thematic coding of transcribed data.
• Review of program documents and routinely collected data.

Main Results:

• Expansion involved 12 public health partners, leading to 167 clients initiating PrEP.
• Facilitators included early partner engagement, model acceptability, and adaptability.
• Barriers included communication adaptation, engaging underserved populations, and the COVID-19 pandemic.

Conclusions:

• Public health and telehealth partnerships can scale to state levels, enhancing PrEP implementation in rural and urban areas.
• Balancing adaptability with standardization is crucial for scalable telehealth-HIV prevention programs.