Our Take
Removing the in-person clinic visit from PrEP initiation matters only if it actually moves the 36% adoption needle; the announcement doesn't report enrollment or adherence outcomes yet.
Why it matters
HIV prevention depends on access, and stigma and clinic friction have kept two-thirds of eligible patients untreated. A fully remote workflow with insurance coverage removes two documented barriers at once.
Do this week
Healthcare leaders: audit your infectious disease intake workflows this week to identify which steps truly require in-person presence versus which persist by habit.
Mount Sinai Launches Fully Remote PrEP Program
Mount Sinai Health System has deployed a fully remote telehealth program for pre-exposure prophylaxis (PrEP), the primary preventive therapy for HIV-negative individuals at risk of infection. The program, built in collaboration with Wisp, allows patients to complete at-home testing and receive insurance-covered prescriptions within 24 to 48 hours of lab results. Quarterly follow-up testing is required to support medication adherence.
The move builds on Mount Sinai's existing hybrid tele-PrEP pilot launched in 2022, which required patients to attend in-person clinical visits for lab work before telehealth consultations. The new fully remote model eliminates that clinic step entirely.
Coverage includes most commercial and private insurance plans. The program targets a documented access gap: only 36% of individuals who meet clinical criteria for PrEP have been prescribed it (per Mount Sinai's announcement). New York City recorded 1,791 new HIV diagnoses in 2024, with the majority occurring in underserved communities.
Access and Stigma Drive Adoption Barriers
PrEP is one of the most effective HIV prevention tools available, with documented efficacy above 99% when taken consistently. Yet the gap between eligible patients and those receiving prescriptions suggests the barrier is not clinical evidence but logistical and social friction.
Two friction points are documented in the announcement: the need to attend an in-person clinic visit and the association between in-clinic HIV prevention services and lingering stigma. The fully remote model removes both. At-home testing eliminates a visibility step; rapid turnaround reduces decision latency; and insurance coverage removes out-of-pocket cost.
What the announcement does not yet show is whether the removal of these barriers actually moves adoption rates. No enrollment figures, completion rates, or adherence outcomes are included. The program is newly launched, so follow-up data may not exist. That gap matters because access alone does not guarantee use if patients still encounter friction downstream (e.g., insurance denials at the pharmacy step, side-effect management without support, or loss to follow-up at the quarterly testing interval).
What to Track and What to Ask
The program's success depends on measurement at three points: initiation (how many eligible patients complete intake and receive a prescription), persistence (how many fill the prescription at the pharmacy), and adherence (how many return for quarterly testing and continue the medication).
If you lead a health system evaluating remote care workflows, this model offers a reproducible template: identify your in-person requirement, test whether telehealth can substitute, and measure drop-off at each step. The principle applies beyond HIV prevention to any chronic disease initiation where early friction is known to harm adoption.
For now, the announcement confirms that Mount Sinai has removed a documented barrier. Confirming that removal improves outcomes will require six to twelve months of enrollment and adherence data.