Expanding PrEP Access Through Decentralized Delivery Models.

PURPOSE OF REVIEW: This review examines emerging PrEP delivery models designed to expand access to HIV prevention outside of traditional clinic settings. It aims to synthesize recent evidence from these models on PrEP uptake, acceptability, and persistence, as well as geographic, social, and structural challenges, drawing on both the research literature and insights from recent programs. RECENT FINDINGS: Recent studies have highlighted the potential of decentralized PrEP delivery approaches, including community-based distribution, pharmacy-based PrEP provision, telePrEP, and automated PrEP dispensing. These models can improve access, reduce stigma, and provide more personalized care. Hybrid approaches and integration of digital tools and peer support have also shown promise in enhancing adherence and retention. However, challenges related to effectiveness, scalability, regulatory constraints, and cost-effectiveness remain. Decentralized PrEP delivery models offer flexible, client-centered solutions that can significantly expand access to HIV prevention for vulnerable groups. Future research should focus on implementation and policy innovation to support integratration of these models into existing health systems and reach underserved populations.