Human Enough: A Qualitative Study of Client Experience With Internet-Based Access to Pre-exposure Prophylaxis

Area of Science:

• Public Health
• Digital Health
• HIV Prevention

Background:

• HIV pre-exposure prophylaxis (PrEP) is crucial for preventing HIV infection.
• Barriers to PrEP include limited prescriber access, discomfort with sexual health services, and discrimination.
• Key populations remain underrepresented in PrEP uptake in the US.

Purpose of the Study:

• To explore client experiences with digital PrEP access via Nurx.
• To assess how telehealth format impacts PrEP engagement.
• To understand if Nurx reduces barriers to PrEP access.

Main Methods:

• 31 PrEP requesters from four US states participated.
• Methods included electronic chart review and semistructured interviews.
• Interview data underwent inductive and deductive thematic analysis.

Main Results:

• Clients reported initial skepticism but overall satisfaction with Nurx.
• Nurx eased access barriers through knowledgeable prescribers and reduced discrimination.
• Client satisfaction stemmed from a balance of efficiency (convenience, speed) and humanity (personalized interaction).

Conclusions:

• Internet-based PrEP provision, like Nurx, expands access to HIV prevention.
• Telehealth effectiveness depends on culturally competent providers and addressing digital access hurdles.
• Intervention design must consider patient experiences and social context, not just technology.