HIV research & clinical practice · 2025
Pilot outcomes of a telehealth model for youth PrEP (TelePrEP) among youth at risk for HIV in Colorado.
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Abuogi Lisa Lynn, Imran Rabbia, Limas Alexander, Moor Jennifer, Leonard Katherine, Pierce Kimberly, De La Garza A J, Gallegos Samantha, Duenas Jacob, Littrell Zachary, Vyas Priya, Richards Molly, Straub Diane, McFarland Elizabeth J
Аннотация
INTRODUCTION: Despite youth representing a large proportion of incident human immunodeficiency virus (HIV) infections in the United States, uptake and retention of youth on pre-exposure prophylaxis (PrEP) remain low. This study evaluated the feasibility and effectiveness of a telehealth model for youth PrEP (TelePrEP) among individuals assigned male at birth at risk for HIV in Colorado.
METHODS: A mixed-methods pilot feasibility trial of telehealth-delivered PrEP services was conducted between January 2023 and December 2024. Youths 14-24 years of age eligible for PrEP using oral tenofovir alafenamide and emtricitabine (F/TAF) were enrolled in a prospective type 1 hybrid effectiveness implementation study. The primary effectiveness outcome was retention, defined as having either a PrEP visit or a PrEP prescription refill 12 months after study enrollment (+/- three months). Additional youth 18-24 years and PrEP providers were recruited for interviews or focus groups to explore implementation determinants such as youth PrEP and service model preferences, facilitators, and barriers. Rapid qualitative analysis was employed to summarize qualitative findings.
RESULTS: Among 44 eligible survey respondents, 21 enrolled in the study, with a median age of 22 years (interquartile range (IQR) 21-24). Eleven (52.4%) of the 21 participants initiated PrEP, and five (23.8%, 95% confidence interval 19.5%-43.3%) were retained per the study definition at 12 months. PrEP persistence (time to first discontinuation) was a median of 33 weeks (IQR 21-57). TelePrEP usage, assessed by the percentage of participants having at least 2 telehealth visits, was ten (47.6%) out of 21 enrolled participants and ten (90.1%) out of 11 participants who initiated PrEP. Qualitative findings among youth were favorable to the study recruitment approaches, including social media use, primary care providers referrals and youth-serving organizations, and community events. Both youth and PrEP providers support a TelePrEP care model.
CONCLUSIONS: PrEP uptake and retention remain challenging for youth at risk for HIV. Further tailoring of PrEP models of care is needed to achieve risk reduction goals for youth.
METHODS: A mixed-methods pilot feasibility trial of telehealth-delivered PrEP services was conducted between January 2023 and December 2024. Youths 14-24 years of age eligible for PrEP using oral tenofovir alafenamide and emtricitabine (F/TAF) were enrolled in a prospective type 1 hybrid effectiveness implementation study. The primary effectiveness outcome was retention, defined as having either a PrEP visit or a PrEP prescription refill 12 months after study enrollment (+/- three months). Additional youth 18-24 years and PrEP providers were recruited for interviews or focus groups to explore implementation determinants such as youth PrEP and service model preferences, facilitators, and barriers. Rapid qualitative analysis was employed to summarize qualitative findings.
RESULTS: Among 44 eligible survey respondents, 21 enrolled in the study, with a median age of 22 years (interquartile range (IQR) 21-24). Eleven (52.4%) of the 21 participants initiated PrEP, and five (23.8%, 95% confidence interval 19.5%-43.3%) were retained per the study definition at 12 months. PrEP persistence (time to first discontinuation) was a median of 33 weeks (IQR 21-57). TelePrEP usage, assessed by the percentage of participants having at least 2 telehealth visits, was ten (47.6%) out of 21 enrolled participants and ten (90.1%) out of 11 participants who initiated PrEP. Qualitative findings among youth were favorable to the study recruitment approaches, including social media use, primary care providers referrals and youth-serving organizations, and community events. Both youth and PrEP providers support a TelePrEP care model.
CONCLUSIONS: PrEP uptake and retention remain challenging for youth at risk for HIV. Further tailoring of PrEP models of care is needed to achieve risk reduction goals for youth.