| Sumario: | The Philippines faces a rising HIV epidemic despite global declines, partly due to limited access to pre-exposure prophylaxis (PrEP). SAIL-teleprep, a telehealth-based differentiated service delivery model, was implemented to expand PrEP access among key populations (KPs) in underserved areas. Using the RE-AIM framework, this study evaluated its first-year implementation through a retrospective cohort analysis of 5,876 PrEP clients across four clinics in 2023. Of these, 8.4% accessed SAIL-teleprep, with higher uptake among clients aged > 24, residing outside Greater Manila, and identifying as men who have sex with men or sex workers. PrEP persistence among teleprep users was high (86.5%). Uptake varied by clinic, and use of courier deliveries peaked seasonally. Findings highlight SAIL-teleprep's potential to reach underserved groups while maintaining adherence. However, gaps remain in engaging younger KPs and people who inject drugs, underscoring the need for adaptable, client-centered strategies in decentralized HIV prevention.
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