Exploring attitudes towards telemedicine use among people receiving Pre-Exposure Prophylaxis (PrEP): a cross-sectional study (Preprint)

BACKGROUND Following the COVID-19 pandemic, telehealth has emerged as a potential tool to improve access to HIV prevention services like Pre-Exposure Prophylaxis (PrEP). However, data on its acceptance among PrEP users in Italy remains limited. OBJECTIVE Aim of this study is to assess attitudes toward telemedicine among PrEP users in a monocentric Italian cohort. METHODS A cross-sectional survey was conducted at a Padua University Hospital PrEP clinic from April to October 2024, consecutively recruiting 450 attendees. Participants completed an adapted, validated questionnaire evaluating willingness, perceived benefits, and concerns regarding telehealth. Associations with demographic and clinical variables were analyzed using multivariate linear regression and clustering techniques RESULTS The cohort was predominantly composed of men who have sex with men (MSM) (90.4%), was largely Italian (92.2%), and included 54.7% of participants under 40 years of age. Most participants (62.4%) reported using on-demand PrEP. Positive attitudes toward telemedicine were significantly associated with higher educational attainment, having a partner living with HIV, and a history of sexually transmitted infections. In contrast, older age and lack of access to appropriate communication tools were associated with lower perceived benefits and greater concerns regarding telemedicine. No significant associations were observed with distance from the hospital or nationality. CONCLUSIONS Telehealth for PrEP delivery was widely accepted in this cohort, particularly among younger, digitally equipped MSM. The findings suggest TelePrEP could be a useful complementary tool to traditional clinic visits. However, acceptability must be further explored in more diverse and vulnerable populations to ensure equitable service delivery.