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Lower self-efficacy and lower PrEP stigma predict telePrEP preferences among HIV self-testers
Cedric Bien-Gund1,2,3, Robert Gross1,2,3, Javontae Williams4
1Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA.
Journal of Acquired Immune Deficiency Syndromes (1999)
|June 26, 2026
Summary
Telehealth-based PrEP (telePrEP) is preferred by over half of individuals who self-test for HIV, especially cis-gender women and those with lower self-efficacy. Integrating telePrEP linkage with stigma reduction is key for effective HIV prevention.
Area of Science:
- Public Health
- HIV Prevention
- Telehealth
Background:
- Remote health services like HIV self-testing (HIVST) and telehealth-based PrEP (telePrEP) aim to reduce barriers to HIV prevention care.
- This study evaluated preferences for telePrEP among individuals who completed HIVST.
Purpose of the Study:
- To assess preferences for telePrEP services among individuals who obtained HIV self-testing (HIVST).
- To investigate the association between telePrEP preferences and factors like self-efficacy and PrEP stigma.
Main Methods:
- Eligible participants (≥17 years) who completed HIVST and reported negative results were recruited.
- An online survey assessed PrEP knowledge, stigma, norms, and self-efficacy.
- Multivariable logistic regression analyzed preferences for telePrEP versus in-person PrEP.
Main Results:
- 55% of 277 participants preferred telePrEP over in-person PrEP.
- Preferences for telePrEP were higher among cis-gender women, individuals with lower PrEP self-efficacy, college education, and higher PrEP social norms.
- Contrary to hypotheses, telePrEP preference was associated with lower PrEP stigma.
Conclusions:
- Linking individuals to telePrEP after HIVST can overcome logistic barriers and support those with low self-efficacy.
- TelePrEP may not fully address PrEP stigma; stigma reduction efforts should be integrated into linkage interventions.
- Findings can inform differentiated PrEP delivery models for timely linkage to care post-self-testing.
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