Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Oct 11, 2024
Open Peer Review Period: Oct 15, 2024 - Dec 10, 2024
Date Accepted: Feb 18, 2025
(closed for review but you can still tweet)
Agreements and disagreements between professionals and users about the experience of a telehealth service for HIV pre-exposure prophylaxis (telePrEP) in Brazil: a qualitative study
ABSTRACT
Background:
Background:
Men who have sex with men face high HIV prevalence globally. In Brazil, the prevalence among MSM is over 15%. Strategies such as pre-exposure prophylaxis (PrEP) are crucial to reduce HIV transmission. However, barriers such as stigma, low-risk perception, and logistical challenges in attending regular clinical appointments hinder broader PrEP coverage and adherence.
Objective:
Objective:
We analyzed the perceptions and experiences of users and healthcare professionals about PrEP clinical follow-up via asynchronous remote consultations (telePrEP) of five PrEP services in three Brazilian regions (Southeast, South, and Northeast).
Methods:
Methods:
We interviewed 19 users, primarily cisgender men, and six healthcare professionals. The interviews addressed motivations and experiences with in-person and remote PrEP and were thematically analyzed using the QSR Nvivo® software.
Results:
Results:
Our study highlights the divergence in perceptions between PrEP users and healthcare professionals regarding telemedicine, emphasizing its potential to enhance autonomy while raising concerns about care quality. Users, primarily cisgender men, positively evaluated telePrEP and highlighted practicality, autonomy, and reduced stigma as benefits of telePrEP. They reported less embarrassment when sharing personal information remotely and the convenience of avoiding frequent trips to healthcare facilities. Healthcare professionals, on the other hand, expressed concerns about losing a bond with patients and potentially reducing the quality of care due to the lack of face-to-face interactions.
Conclusions:
Conclusions:
The successful implementation of telehealth services for PrEP must account for the differing perspectives of users and healthcare professionals to ensure comprehensive and inclusive care. Our findings underscore the need for further research beyond large urban centers in Brazil to capture diverse socioeconomic contexts and to strengthen healthcare professionals' training, equipping them to address the unique challenges of PrEP care effectively.
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Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.