TYPE Study Protocol PUBLISHED 24 February 2023 DOI 10.3389/fpubh.2023.1054559 OPEN ACCESS EDITED BY Pritesh Mistry, The Kings Fund, United Kingdom REVIEWED BY Colleen Mistler, University of Connecticut, United States Archana Krishnan, University at Albany, State University of New York, United States *CORRESPONDENCE Katrina F. Ortblad kortblad@fredhutch.org † These authors have contributed equally to this work and share senior authorship SPECIALTY SECTION This article was submitted to Digital Public Health, a section of the journal Frontiers in Public Health RECEIVED 27 September 2022 ACCEPTED 31 January 2023 PUBLISHED 24 February 2023 CITATION Kiptinness C, Naik P, Thuo N, Malen RC, Dettinger JC, Pintye J, Rafferty M, Jomo E, Nyamasyo N, Wood T, Isabelli P, Morris S, Hattery D, Stergachis A, Were D, Sharma M, Ngure K, Mugambi ML and Ortblad KF (2023) Online HIV prophylaxis delivery: Protocol for the ePrEP Kenya pilot study. Front. Public Health 11:1054559. doi: 10.3389/fpubh.2023.1054559 COPYRIGHT © 2023 Kiptinness, Naik, Thuo, Malen, Dettinger, Pintye, Rafferty, Jomo, Nyamasyo, Wood, Isabelli, Morris, Hattery, Stergachis, Were, Sharma, Ngure, Mugambi and Ortblad. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. Online HIV prophylaxis delivery: Protocol for the ePrEP Kenya pilot study Catherine Kiptinness 1 , Paulami Naik 2 , Nicholas Thuo 1 , Rachel C. Malen 3 , Julia C. Dettinger 2 , Jillian Pintye 4 , Maeve Rafferty 5 , Edwin Jomo 5 , Nicky Nyamasyo 5 , Tony Wood 5 , Paul Isabelli 6 , Sarah Morris 6 , David Hattery 6 , Andy Stergachis 2,7 , Daniel Were 8 , Monisha Sharma 2 , Kenneth Ngure 9 , Melissa Latigo Mugambi 2† and Katrina F. Ortblad 3 * † 1 Partners in Health Research and Development, Center for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya, 2 Department of Global Health, University of Washington, Seattle, WA, United States, 3 Public Health Science Division, Fred Hutchinson Cancer Center, Seattle, WA, United States, 4 Department of Biobehavioral Nursing and Health Informatics, Seattle, WA, United States, 5 MYDAWA, Nairobi, Kenya, 6 Audere, Seattle, WA, United States, 7 Department of Pharmacy, University of Washington, Seattle, WA, United States, 8 Jhpiego, Nairobi, Kenya, 9 School of Public Health, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya Background: Online pharmacies in Kenya provide sexual and reproductive health products (e.g., HIV self-testing, contraception) and could be leveraged to increase the reach of HIV pre-exposure and post-exposure prophylaxis (PrEP/PEP) to populations who do not frequently attend health facilities. To date, evidence is limited for operationalizing online PrEP/PEP delivery and the type of populations reached with this differential service delivery model. Methods: The ePrEP Kenya Pilot will deliver daily oral PrEP and PEP via MYDAWA, a private online pharmacy retailer, to clients in Nairobi for 18 months. Potential clients will obtain information about PrEP/PEP on MYDAWA’s sexual wellness page and self-screen for HIV risk. Individuals ≥18 years, identified as at HIV risk, and willing to pay for a blood-based HIV self-test and PrEP/PEP delivery will be eligible for enrollment. To continue with online PrEP/PEP initiation, eligible clients will purchase a blood-based HIV self-test for 250 KES (∼USD 2) [delivered to their setting of choice for 99 KES (∼USD 1)], upload an image of their self-test result, and attend a telemedicine visit with a MYDAWA provider. During the telemedicine visit, providers will screen clients for PrEP/PEP eligibility, including clinical concerns (e.g., kidney disease), discuss self-test results, and complete counseling on PrEP/PEP use and safety. Providers will refer clients who self-test HIV positive or report any existing medical conditions to the appropriate services at healthcare facilities that meet their preferences. Eligible clients will be prescribed PrEP (30-day PrEP supply at initiation; 90-day PrEP supply at follow-up visits) or PEP (28-day supply) for free and have it delivered for 99 KES (∼USD 1). We will measure PrEP and PEP initiation among eligible clients, PEP-to-PrEP transition, PrEP continuation, and implementation outcomes (e.g., feasibility, acceptability, and costs). Discussion: Establishing pathways to increase PrEP and PEP access is crucial to help curb new HIV infections in settings with high HIV prevalence. The findings Frontiers in Public Health 01 frontiersin.org