{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T05:47:47Z","timestamp":1782193667191,"version":"3.54.5"},"reference-count":36,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:00:00Z","timestamp":1780531200000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Online delivery of HIV pre\u2010 and post\u2010exposure prophylaxis (PrEP and PEP) could address persistent access barriers, yet implementation across Africa remains limited. The ePrEP Kenya Pilot (NCT05377138) integrated PrEP and PEP services into an existing e\u2010pharmacy platform and identified client\u2010 and provider\u2010level barriers and facilitators to use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In the pilot, clinicians screened adults (age 18+) in Nairobi and Mombasa Counties for PrEP and PEP eligibility via telehealth; pharmaceutical technologists courier\u2010delivered HIV testing services (including self\u2010testing) and dispensed PrEP or PEP to eligible clients who paid 150\u2013250 KES (\u223c$1\u20132 USD) for HIV testing, \u2264149 KES (\u223c$1 USD) for courier delivery and nothing for telehealth consultation or PrEP\/PEP drugs. We conducted monthly check\u2010in calls with providers and, near study endline, in\u2010depth interviews (IDIs) with purposively sampled clients and all providers. We analysed verbatim call transcripts and IDIs inductively, then mapped identified barriers and facilitators to the Consolidated Framework for Implementation Research (CFIR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>From February to November 2023, we conducted 10 check\u2010in calls and interviewed 30 clients (10 PEP, 10 PrEP with 1+ refill, 10 PrEP with no refills) and 10 providers (4 clinicians, 6 pharm techs). Clients had a median age of 27 years (IQR 25\u201330) and providers 28 years (IQR 27\u201331); 53% (16\/30) of clients and 30% (3\/10) of providers were female. In the Outer Setting CFIR domain, providers identified motorcycle manoeuvrability as a delivery facilitator but noted that traffic, poor road infrastructure, bad weather and personal safety concerns posed challenges. In the Inner Setting domain, providers identified information\u2010sharing practices and collegiality as facilitators. In the Individuals domain, clients\u2019 capability, opportunity and motivation to use online PrEP\/PEP services was reportedly facilitated by app\u2010guided HIV self\u2010testing, broad delivery zones and enhanced privacy, but hindered by low awareness of these services, limited access to internet\u2010enabled devices, data security concerns and uncertainties around couriers\u2019 pharmacy credentials. Recommendations included reducing client costs, expanding delivery coverage and hours, and offering alternative delivery options (e.g. medication pick\u2010up lockers).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Online PrEP and PEP delivery is a promising differentiated service model, especially if partially subsidized by third\u2010party payers. Implementation success will require model adaptations that address logistical, infrastructural and awareness barriers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jia2.70133","type":"journal-article","created":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T06:05:28Z","timestamp":1780639528000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Qualitative Insights on Client and Provider Barriers and Facilitators to Using a Novel Online HIV Pre\u2010 and Post\u2010Exposure Delivery Model in Kenya"],"prefix":"10.1002","volume":"29","author":[{"given":"Phelix","family":"Okello","sequence":"first","affiliation":[{"name":"Partners in Health Research and Development Center for Clinical Research Kenya Medical Research Institute  Nairobi Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Thuo","sequence":"additional","affiliation":[{"name":"Partners in Health Research and Development Center for Clinical Research Kenya Medical Research Institute  Nairobi Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie D.","family":"Roche","sequence":"additional","affiliation":[{"name":"Public Health Science Division Fred Hutchinson Cancer Center  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arden L.","family":"Saravis","sequence":"additional","affiliation":[{"name":"Department of Global Health University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Mwai","sequence":"additional","affiliation":[{"name":"Partners in Health Research and Development Center for Clinical Research Kenya Medical Research Institute  Nairobi Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulami","family":"Naik","sequence":"additional","affiliation":[{"name":"Department of Global Health University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Kiptinness","sequence":"additional","affiliation":[{"name":"Partners in Health Research and Development Center for Clinical Research Kenya Medical Research Institute  Nairobi Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tabitha","family":"Kareithi","sequence":"additional","affiliation":[{"name":"Partners in Health Research and Development Center for Clinical Research Kenya Medical Research Institute  Nairobi Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa L.","family":"Mugambi","sequence":"additional","affiliation":[{"name":"Department of Global Health University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7599-1561","authenticated-orcid":false,"given":"Monisha","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Global Health University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"Ngure","sequence":"additional","affiliation":[{"name":"Department of Global Health University of Washington  Seattle Washington USA"},{"name":"School of Public Health Jomo Kenyatta University of Agriculture and Technology  Nairobi Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5675-8836","authenticated-orcid":false,"given":"Katrina F.","family":"Ortbald","sequence":"additional","affiliation":[{"name":"Public Health Science Division Fred Hutchinson Cancer Center  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,4]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/platforms2010003"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2589-7500(20)30027-3"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.25439"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0227632"},{"key":"e_1_2_12_6_1","unstructured":"UNAIDS The Urgency of Now: AIDS at a Crossroads\u20142024 Global AIDS Update (Joint United Nations Programme on HIV\/AIDS 2024) [cited 2026]. 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