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Publication Profiles

Facilitators and Barriers to Equitable Implementation of Telehealth PrEP Delivery: A Qualitative Descriptive Study of Program Staff and Stakeholders

Citation

Bonett S, Sweeney A, Li Q, et al. Facilitators and Barriers to Equitable Implementation of Telehealth PrEP Delivery: A Qualitative Descriptive Study of Program Staff and Stakeholders. Health Promot Pract. 2026;27(3):564-575. doi:10.1177/15248399251347253

Implementation stage:

Implementation

Implementation outcomes reported:

Not applicable

Continuum target addressed:

PrEP initiPhiladelphia County-PAation, PrEP adherence, PrEP persistence

Geography:

Philadelphia County-PA

Study Participant Classification:

Implementer(s), Providers

Plain Language Objectives

The researchers interviewed Philadelphia telehealth PrEP staff and other HIV-prevention stakeholders. They wanted to understand what supported the program, which people might be missed, and what funding, staffing, technology, and outreach barriers could affect equitable delivery.

Plain Language Abstract

Telehealth may expand access to pre-exposure prophylaxis, or PrEP, but digital services can also reproduce existing inequities. Researchers conducted nine in-depth interviews: five with Philadelphia TelePrEP staff and four with external HIV-prevention stakeholders. Participants said telehealth improved convenience and flexibility. Dedicated patient navigators, continuing staff training, and sustainable financing through grants and 340B revenue helped the program serve uninsured patients. Challenges included limited provider capacity, low public awareness of PrEP, the digital divide, and competition from commercial telehealth providers. Participants also warned that online marketing may miss people with little digital presence, including some priority populations. The findings identify organizational and structural conditions that may influence equitable implementation. Because this qualitative study involved nine staff and stakeholders, it reflects their perspectives rather than patient experiences or population-wide estimates. It did not compare telehealth with in-person care or test whether the program increased PrEP initiation, adherence, persistence, or reduced disparities.

Key Takeaways

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