In the United States, young men who have sex with men (YMSM) of color represent a high number of new HIV diagnoses annually. HIV pre-exposure prophylaxis (PrEP) is effective and acceptable to YMSM of color; yet, PrEP uptake is low in those communities because of barriers including stigma, cost, adherence concerns, and medical distrust. A telehealth-based approach to PrEP initiation may be a solution to those barriers. This pilot study investigates one such intervention called PrEPTECH.
We enrolled 25 HIV-uninfected YMSM, aged 18–25 years, from the San Francisco Bay Area into a 180-day longitudinal study between November 2016 and May 2017. Participants received cost-free PrEP services through telehealth [eg, telemedicine visits, home delivery of Truvada, and sexually transmitted infection testing kits], except for 2 laboratory visits. Online survey assessments querying PrEPTECH features and experiences were administered to participants at 90 and 180 days.
Eighty-four percent of participants were YMSM of color. Among the 21 who completed the study, 11 of the 16 who wanted to continue PrEP were transitioned to sustainable PrEP providers. At least 75% felt that PrEPTECH was confidential, fast, convenient, and easy to use. Less than 15% personally experienced PrEP stigma during the study. The median time to PrEP initiation was 46 days. Sexually transmitted infection positivity was 20% and 19% at baseline and 90 days, respectively. No HIV infections were detected.
Telehealth programs such as PrEPTECH increase PrEP access for YMSM of color by eliminating barriers inherent in traditional clinic-based models.
*David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA;
†Division of Infectious Diseases, Department of Medicine, University of California Los Angeles, Los Angeles, CA;
‡Youth Tech Health (YTH), San Francisco, CA; and
§San Francisco State University, Center for Research and Education on Gender and Sexuality, San Francisco, CA.
Correspondence to: Oliver N. Refugio, MD, MPH, David Geffen School of Medicine, University of California Los Angeles, 10833 Le Conte Avenue, Los Angeles, CA 90095 (e-mail: firstname.lastname@example.org).
Supported by Gilead Sciences, Inc., and the National Institutes of Health (grant numbers AI028697, P30MH058107).
The authors have no funding or conflicts of interest to disclose.
Received May 21, 2018
Accepted September 13, 2018