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In collaboration with a private e\u2010commerce platform and online pharmacy in Kenya, MYDAWA, we piloted a new model of HIV pre\u2010 and post\u2010exposure prophylaxis (PrEP\/PEP) delivery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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. \u226518 years; no medical contraindications). Eligible individuals could order HIV testing services\u2014courier delivered to clients\u2019 choice location\u2014for a fee of 250 KES (\u223c$2 USD) for self\u2010testing or 150 KES (\u223c$1 USD) for provider\u2010administered rapid diagnostic testing. Following confirmation of clients\u2019 HIV\u2010negative 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 \u2264149 KES (\u223c$1 USD) per courier visit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>From October 2022 to December 2023, we screened 2257 individuals and enrolled 1915. Most PrEP\/PEP clients were men (63%, 1428\/1915), \u226525 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\u2010eligible clients, 89% (203\/227) completed HIV testing and 92% (208\/227) received PrEP; among PEP\u2010eligible 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\u2010up, 47% (120\/256) continued PrEP and 4% (10\/256) initiated PEP following PrEP discontinuation. Among PEP clients eligible for follow\u2010up, 7% (99\/1428) repeated PEP use and 6% (83\/1428) transitioned from PEP to PrEP.).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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\u2010sensitive PEP services.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jia2.26468","type":"journal-article","created":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T13:05:28Z","timestamp":1750943128000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Online delivery of oral HIV pre\u2010 and post\u2010exposure prophylaxis: findings from the ePrEP Kenya pilot"],"prefix":"10.1002","volume":"28","author":[{"given":"Catherine","family":"Kiptinness","sequence":"first","affiliation":[{"name":"Center for Clinical Research Kenya Medical Research Institute  Nairobi 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