Implementation determinants and outcomes in the Philadelphia TelePrEP Program: a mixed methods study of client and...

Area of Science:

• Public Health
• Implementation Science
• Digital Health

Background:

• HIV pre-exposure prophylaxis (PrEP) uptake remains below targets.
• Telehealth offers a promising solution to overcome PrEP access barriers.
• Understanding telehealth implementation for PrEP is crucial.

Purpose of the Study:

• Examine implementation barriers and facilitators in the Philadelphia TelePrEP Program (PTP).
• Assess program acceptability, usability, and satisfaction.
• Investigate associations between client characteristics and implementation outcomes.

Main Methods:

• Mixed-methods evaluation (October 2023 - February 2025).
• Web-based surveys (n=113) and in-depth staff interviews (n=5).
• Qualitative analysis guided by the Consolidated Framework for Implementation Research; linear regression for characteristic associations.

Main Results:

• High acceptability, usability, and satisfaction reported, with lower scores for unemployed participants.
• Patient navigators identified as key facilitators; billing, platform integration, and privacy as barriers.
• Demand for in-person services highlighted need for hybrid models; challenges in reaching priority populations noted.

Conclusions:

• TelePrEP programs can achieve high satisfaction with navigation and flexibility.
• Strategies needed to enhance reach, coordination, and hybrid models for diverse needs.
• Addressing patient preferences and socioeconomic factors is vital for full potential.