Resum

Background: Kimirina, in coordination with the Ministry of Public Health, initiated the PrEP program in Ecuador in August 2019. Initially, in-person medical services were of- fered, which were obviously suspended during the lock- down in Covid-19 pandemic. During this period, a telem- atic scheduling and PrEP service system was developed, allowing users to access the service through a computer or a mobile phone. Between August 2019 and July 2023, a total of 1,338 individuals, including MSM, transfeminine, sex workers, and serodiscordant, have accessed PrEP. Description: Kimirina ‚s telematic system employs three types of tools: 1. A social network through which scheduling is established, and the user opens their file; 2. Interactive telemedicine through video calls using a web platform; 3. Digital health records developed in compliance with standard care requirements, incorporating the specificity of PrEP care. These records are stored to ensure the confi- dentiality and integrity of information; 4. The use of a widely used social network for receiving examination requests and prescriptions. The telematic system is supported by Kimirina‘s network of community centers. Lessons learned: During the analysis period, there is a clear upward trend in the number of individuals accessing the PrEP program each year. In 2019, 93 individuals were served, which increased to 555 in 2021 and 819 until July 2023 through the telematic system. It is worth noting that Kimirina provides in-person services, but these are rarely requested by PrEP users. Through the telematic system, users from 22 out of 24 provinces in Ecuador have been attended to. Conclusions/Next steps: The potential to utilize technological systems enables greater access to combined prevention mechanisms and contributes to achieving the goal of ending the AIDS epidemic by 2030. Kimirina‘s telematic system is well-received by users as it reduces waiting times and facilitates access to complementary services, such as in-person HIV screening and laboratory testing.