Bridging gaps: Demographic insights into utilization and engagement in Los Angeles County, California's TelePrEP HIV prevention program

Objectives In alignment with the Ending the HIV Epidemic (EHE) Initiative, the Los Angeles County Department of Public Health launched TelePrEP in May 2023 to expand access to HIV prevention services. This study aimed to examine predictors of engagement in care, including demographic characteristics, and insurance status. Methods This retrospective cohort study used de-identified data from 412 clients during the program's operation from May 2023 through May 2025. Engagement was measured as completion of three or more quarterly visits versus fewer than three visits. Bivariate analysis and Logistic regression assessed associations between engagement and client demographics. Results The cohort was predominantly male (91.70%), Hispanic/Latino (48.10%), and aged 18–39 years (72.60%). Majority of clients disenrolled (53.80%) were attributed to adherence/compliance challenges. Completion of three or more quarterly visits was not significantly associated with gender, age, race/ethnicity, or insurance status in either bivariate or adjusted analyses. Conclusion In this large urban TelePrEP program, no statistically significant associations were detected between the measured variables and completion of three or more quarterly visits. Small subgroup sizes and wide confidence intervals limit interpretation. Findings support strengthening early engagement and reengagement strategies, although interpretation is limited by small subgroup sizes.