Online delivery of oral HIV pre‐ and post‐exposure prophylaxis: findings from the ePrEP Kenya pilot
Abstract Introduction The expansion of telecommunication networks and smartphones in many African countries could be leveraged to deliver HIV prevention products directly to consumers. In collaboration with a private e‐commerce platform and online pharmacy in Kenya, MYDAWA, we piloted a new model of...
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2025-06-01
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| Series: | Journal of the International AIDS Society |
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| Online Access: | https://doi.org/10.1002/jia2.26468 |
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| author | Catherine Kiptinness Paulami Naik Tabitha Kareithi Nicholas Thuo Phelix Okello Carlos Culquichicon Maeve Rafferty Samira Abdulrashid Edwin Jomo Nicky Nyamasyo Tony Wood Rouella Mendonca Rachel C. Malen Julia C. Dettinger Jillian Pintye June Mwangi Andy Stergachis Jonah Onentia Kelly Curran Melissa Latigo Mugambi Daniel Were Kenneth Ngure Monisha Sharma Katrina F. Ortblad the ePrEP Kenya team |
| author_facet | Catherine Kiptinness Paulami Naik Tabitha Kareithi Nicholas Thuo Phelix Okello Carlos Culquichicon Maeve Rafferty Samira Abdulrashid Edwin Jomo Nicky Nyamasyo Tony Wood Rouella Mendonca Rachel C. Malen Julia C. Dettinger Jillian Pintye June Mwangi Andy Stergachis Jonah Onentia Kelly Curran Melissa Latigo Mugambi Daniel Were Kenneth Ngure Monisha Sharma Katrina F. Ortblad the ePrEP Kenya team |
| author_sort | Catherine Kiptinness |
| collection | DOAJ |
| description | Abstract Introduction The expansion of telecommunication networks and smartphones in many African countries could be leveraged to deliver HIV prevention products directly to consumers. In collaboration with a private e‐commerce platform and online pharmacy in Kenya, MYDAWA, we piloted a new model of HIV pre‐ and post‐exposure prophylaxis (PrEP/PEP) delivery. Methods In the ePrEP Kenya pilot (NCT05377138), individuals living in Nairobi and Mombasa Counties could complete a free telehealth visit with a remote clinician to assess eligibility for online PrEP/PEP (i.e. ≥18 years; no medical contraindications). Eligible individuals could order HIV testing services—courier delivered to clients’ choice location—for a fee of 250 KES (∼$2 USD) for self‐testing or 150 KES (∼$1 USD) for provider‐administered rapid diagnostic testing. Following confirmation of clients’ HIV‐negative status (via an uploaded test result image), free PrEP/PEP drugs from government supply were courier delivered with or separately from HIV testing services. Clients paid a delivery fee ≤149 KES (∼$1 USD) per courier visit. Results From October 2022 to December 2023, we screened 2257 individuals and enrolled 1915. Most PrEP/PEP clients were men (63%, 1428/1915), ≥25 years (72%, 1631/1915) and never married (80%, 1796/1915); few had ever used PrEP (3%, 48/1915) or PEP (14%, 263/1915). At enrolment, 227 (12%) were preliminarily eligible for PrEP and 1688 (88%) for PEP. Among PrEP‐eligible clients, 89% (203/227) completed HIV testing and 92% (208/227) received PrEP; among PEP‐eligible clients, 92% (1551/1688) completed HIV testing and 92% (1549/1688) received PEP. Most PrEP/PEP clients completed HIV testing within 6 hours of their telehealth visit (53%, 927/1757) and had drugs delivered with testing services (88%, 1546/1757). Among PrEP clients eligible for follow‐up, 47% (120/256) continued PrEP and 4% (10/256) initiated PEP following PrEP discontinuation. Among PEP clients eligible for follow‐up, 7% (99/1428) repeated PEP use and 6% (83/1428) transitioned from PEP to PrEP.). Conclusions Online PrEP/PEP delivery could expand access to prevention services by reaching individuals not engaged in existing delivery platforms. The uptake of online PEP was five times greater than PrEP, underscoring an unmet demand for PEP and highlighting the potential for online pharmacies to deliver time‐sensitive PEP services. |
| format | Article |
| id | doaj-art-2d3cc351a7b14252a45f93e83057c61d |
| institution | Kabale University |
| issn | 1758-2652 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the International AIDS Society |
| spelling | doaj-art-2d3cc351a7b14252a45f93e83057c61d2025-08-20T03:27:58ZengWileyJournal of the International AIDS Society1758-26522025-06-0128S1n/an/a10.1002/jia2.26468Online delivery of oral HIV pre‐ and post‐exposure prophylaxis: findings from the ePrEP Kenya pilotCatherine Kiptinness0Paulami Naik1Tabitha Kareithi2Nicholas Thuo3Phelix Okello4Carlos Culquichicon5Maeve Rafferty6Samira Abdulrashid7Edwin Jomo8Nicky Nyamasyo9Tony Wood10Rouella Mendonca11Rachel C. Malen12Julia C. Dettinger13Jillian Pintye14June Mwangi15Andy Stergachis16Jonah Onentia17Kelly Curran18Melissa Latigo Mugambi19Daniel Were20Kenneth Ngure21Monisha Sharma22Katrina F. Ortblad23the ePrEP Kenya teamCenter for Clinical Research Kenya Medical Research Institute Nairobi KenyaDepartment of Global Health University of Washington Seattle Washington USACenter for Clinical Research Kenya Medical Research Institute Nairobi KenyaCenter for Clinical Research Kenya Medical Research Institute Nairobi KenyaCenter for Clinical Research Kenya Medical Research Institute Nairobi KenyaDepartment of Epidemiology University of Washington Seattle Washington USAMYDAWA Nairobi KenyaMYDAWA Nairobi KenyaMYDAWA Nairobi KenyaMYDAWA Nairobi KenyaMYDAWA Nairobi KenyaAudere Seattle Washington USAPublic Health Sciences Division Fred Hutchinson Cancer Center Seattle Washington USADepartment of Global Health University of Washington Seattle Washington USADepartment of Biobehavioral Nursing and Health Informatics Seattle Washington USAJhpiego Baltimore Maryland USADepartment of Global Health University of Washington Seattle Washington USANational AIDS Control Program Kenya Ministry of Health Nairobi KenyaJhpiego Baltimore Maryland USADepartment of Global Health University of Washington Seattle Washington USAJhpiego Baltimore Maryland USADepartment of Global Health University of Washington Seattle Washington USADepartment of Global Health University of Washington Seattle Washington USAPublic Health Sciences Division Fred Hutchinson Cancer Center Seattle Washington USAAbstract Introduction The expansion of telecommunication networks and smartphones in many African countries could be leveraged to deliver HIV prevention products directly to consumers. In collaboration with a private e‐commerce platform and online pharmacy in Kenya, MYDAWA, we piloted a new model of HIV pre‐ and post‐exposure prophylaxis (PrEP/PEP) delivery. Methods In the ePrEP Kenya pilot (NCT05377138), individuals living in Nairobi and Mombasa Counties could complete a free telehealth visit with a remote clinician to assess eligibility for online PrEP/PEP (i.e. ≥18 years; no medical contraindications). Eligible individuals could order HIV testing services—courier delivered to clients’ choice location—for a fee of 250 KES (∼$2 USD) for self‐testing or 150 KES (∼$1 USD) for provider‐administered rapid diagnostic testing. Following confirmation of clients’ HIV‐negative status (via an uploaded test result image), free PrEP/PEP drugs from government supply were courier delivered with or separately from HIV testing services. Clients paid a delivery fee ≤149 KES (∼$1 USD) per courier visit. Results From October 2022 to December 2023, we screened 2257 individuals and enrolled 1915. Most PrEP/PEP clients were men (63%, 1428/1915), ≥25 years (72%, 1631/1915) and never married (80%, 1796/1915); few had ever used PrEP (3%, 48/1915) or PEP (14%, 263/1915). At enrolment, 227 (12%) were preliminarily eligible for PrEP and 1688 (88%) for PEP. Among PrEP‐eligible clients, 89% (203/227) completed HIV testing and 92% (208/227) received PrEP; among PEP‐eligible clients, 92% (1551/1688) completed HIV testing and 92% (1549/1688) received PEP. Most PrEP/PEP clients completed HIV testing within 6 hours of their telehealth visit (53%, 927/1757) and had drugs delivered with testing services (88%, 1546/1757). Among PrEP clients eligible for follow‐up, 47% (120/256) continued PrEP and 4% (10/256) initiated PEP following PrEP discontinuation. Among PEP clients eligible for follow‐up, 7% (99/1428) repeated PEP use and 6% (83/1428) transitioned from PEP to PrEP.). Conclusions Online PrEP/PEP delivery could expand access to prevention services by reaching individuals not engaged in existing delivery platforms. The uptake of online PEP was five times greater than PrEP, underscoring an unmet demand for PEP and highlighting the potential for online pharmacies to deliver time‐sensitive PEP services.https://doi.org/10.1002/jia2.26468HIV preventionpre‐exposure prophylaxispost‐exposure prophylaxisonline deliverydifferentiated service deliveryHIV self‐testing |
| spellingShingle | Catherine Kiptinness Paulami Naik Tabitha Kareithi Nicholas Thuo Phelix Okello Carlos Culquichicon Maeve Rafferty Samira Abdulrashid Edwin Jomo Nicky Nyamasyo Tony Wood Rouella Mendonca Rachel C. Malen Julia C. Dettinger Jillian Pintye June Mwangi Andy Stergachis Jonah Onentia Kelly Curran Melissa Latigo Mugambi Daniel Were Kenneth Ngure Monisha Sharma Katrina F. Ortblad the ePrEP Kenya team Online delivery of oral HIV pre‐ and post‐exposure prophylaxis: findings from the ePrEP Kenya pilot Journal of the International AIDS Society HIV prevention pre‐exposure prophylaxis post‐exposure prophylaxis online delivery differentiated service delivery HIV self‐testing |
| title | Online delivery of oral HIV pre‐ and post‐exposure prophylaxis: findings from the ePrEP Kenya pilot |
| title_full | Online delivery of oral HIV pre‐ and post‐exposure prophylaxis: findings from the ePrEP Kenya pilot |
| title_fullStr | Online delivery of oral HIV pre‐ and post‐exposure prophylaxis: findings from the ePrEP Kenya pilot |
| title_full_unstemmed | Online delivery of oral HIV pre‐ and post‐exposure prophylaxis: findings from the ePrEP Kenya pilot |
| title_short | Online delivery of oral HIV pre‐ and post‐exposure prophylaxis: findings from the ePrEP Kenya pilot |
| title_sort | online delivery of oral hiv pre and post exposure prophylaxis findings from the eprep kenya pilot |
| topic | HIV prevention pre‐exposure prophylaxis post‐exposure prophylaxis online delivery differentiated service delivery HIV self‐testing |
| url | https://doi.org/10.1002/jia2.26468 |
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