ArticleJournal of the International AIDS Society2023
Telehealth effectiveness for pre-exposure prophylaxis delivery in Brazilian public services: the Combine! Study.
Article in Journal of the International AIDS Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Qualitative Insights on Client and Provider Barriers and Facilitators to Using a Novel Online HIV Pre- and Post-Exposure Delivery Model in Kenya.Journal of the International AIDS Society · 2026Trial
- A qualitative study on pre-exposure prophylaxis uptake and retention among men who have sex with men and transgender women in Myanmar.International health · 2026Article
- Exploring Perceived Utility of a Clinic-Integrated HIV Prevention App for Men Who Have Sex With Men in Malaysia: A Qualitative Think-Aloud Study.Health science reports · 2026Article
- Expanding PrEP Access Through Decentralized Delivery Models.Current HIV/AIDS reports · 2026Review
- Challenges and Opportunities for Improved Tuberculosis and HIV Prevention in South America.Open forum infectious diseases · 2026Review
- Telemedicine Preexposure Prophylaxis Prescribing From a Large Online US Company.JAMA network open · 2025Article
- Perceptions of Daily and On-Demand HIV Pre-Exposure Prophylaxis and Digital Adherence-Support Needs Among Cisgender Men in Brazil: Qualitative Interview and Focus Group Study.Journal of medical Internet research · 2025Article
- Comprehensive Analysis and Leveraging Online Innovations to Improve HIV and STI Prevention and Treatment Services in Major Cities of Thailand.AIDS and behavior · 2025Article
- Agreements and Disagreements Between Professionals and Users About the Experience of a Telehealth Service for HIV Pre-Exposure Prophylaxis (TelePrEP): Qualitative Interview Study.Journal of medical Internet research · 2025Article
- Updates on HIV Pre-exposure Prophylaxis in Latin America: Available Drugs and Implementation Status.Le infezioni in medicina · 2025Review
- Acceptability of Teleconsultation Services for HIV Care in Nigeria: A Mixed Methods Study.Telemedicine journal and e-health : the official journal of the American Telemedicine Association · 2025Article
- Preferences for pre-exposure prophylaxis delivery via online pharmacy among potential users in Kenya: a discrete choice experiment.Journal of the International AIDS Society · 2024Article
Corrections and comments
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Authors and funding
18 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionPre-exposure prophylaxis (PrEP) delivery based on user needs can enhance PrEP access and impact. We examined whether telehealth for daily oral PrEP delivery could change the indicators of care related to prophylactic use in five Brazilian public HIV clinics (testing centres, outpatient clinics and infectious disease hospitals).
methodsBetween July 2019 and December 2020, clients on PrEP for at least 6 months could transition to telehealth or stay with in-person follow-up. Clients were clinically monitored until June 2021. A desktop or mobile application was developed, comprising three asynchronous consultations and one annual in-person consultation visit. Predictors influencing telehealth preference and care outcomes were examined. The analysis encompassed intent-to-treat (first choice) and adjustments for sexual practices, schooling, age, duration of PrEP use and PrEP status during the choice period.
resultsOf 470 users, 52% chose telehealth, with the adjusted odds ratio (aOR) increasing over time for PrEP use (aOR for 25-months of use: 4.90; 95% CI: 1.32-18.25), having discontinued PrEP at the time of the choice (aOR: 2.91; 95% CI: 1.40-6.06) and having health insurance (aOR: 1.91; 95% CI: 1.24-2.94) and decreasing for those who reported higher-risk behaviour (aOR for unprotected anal sex: 0.51; 95% CI: 0.29-0.88). After an average follow-up period of 1.6 years (95% CI: 1.5-1.7), the risk of discontinuing PrEP (not having the medication for more than 90 days) was 34% lower with telehealth (adjusted hazard ratio: 0.66; 95% CI: 0.45-0.97). When adjusted by mixed linear regression, no differences in adherence (measured by mean medication possession rate) were found between in-person and telehealth (p = 0.486) or at pre- and post-telehealth follow-ups (p = 0.245). Sexually transmitted infections increased between the pre-follow-up and post-follow-up choices and were not associated with in-person or telehealth (p = 0.528). No HIV infections were observed.
conclusionsOur findings indicate that telehealth for PrEP delivery can enhance service rationalization and reinforce the prevention cascade. This approach reduces prophylaxis interruptions and is mainly preferred by individuals with lower demands for healthcare services.
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