The Drug Has Been Ready. The System Hasn't

The barriers are structural and well-documented: stigma, provider shortages, insurance complexity, and a deep distrust of healthcare institutions in the communities most affected. "It's unacceptable that so many people still can't access PrEP, given it is one of the most effective solutions we have today to prevent HIV," said Monica Cepak, CEO of Wisp.

Telehealth has made inroads. Nearly 20% of U.S. PrEP users —more than 110,000 people—accessed it via telemedicine in 2024. But most of those programs operate as standalone virtual clinics, disconnected from health systems, primary care records, and the kind of clinical depth that keeps patients engaged over time.

Mount Sinai itself launched a hybrid tele-PrEP program through its Institute for Advanced Medicine in 2022, but it still required patients to visit a clinic for required quarterly lab work. For people navigating stigma or inflexible work schedules, that single requirement was often enough to stop them from starting or staying on treatment.

"At Mount Sinai, our commitment goes beyond just HIV prevention. We're rethinking how care is delivered across the board to make it more proactive, accessible, and patient-centered," said Nicholas Gavin, MD, MBA, MS, vice president and chief clinical innovation officer of the Mount Sinai Health System. “This collaboration is an extension of that, helping us meet people where they are, remove barriers, and bring evidence-based prevention like PrEP into every day, easy-to-access care across New York.”

One Record, Three Ways To Get Care

The structural innovation at the center of this collaboration is deceptively simple: a shared patient record, built on Epic integration, that connects Wisp's telehealth platform to Mount Sinai's clinical system. "It's a consolidated record," Cepak explains. "We're giving patients the option of at-home testing or in-person care, and so it is a shared patient record with information going back and forth."

That integration makes possible a three-tier care mode—fully remote, hybrid, and in-person—on a single coordinated pathway. A patient can start PrEP entirely online, complete required quarterly testing with a kit shipped directly to their home, receive a prescription within 24 to 48 hours of lab results, and never enter a clinic.

Or they can move fluidly between digital and in-person care as their life requires. “PrEP works best when it fits your life; and now you can start it online, on your own time, at your convenience,” said Antonio E. Urbina, MD, professor of medicine and medical director of the Institute for Advanced Medicine at the Icahn School of Medicine at Mount Sinai.

The adherence architecture is as important as the access architecture. Wisp uses a subscription model that ships at-home test kits to patients at precisely the right interval, paired with a system of check-ins and follow-ups. Combined with commercial insurance coverage that brings cost to $0 for 99% of patients, the model removes the three most common reasons people fall off PrEP: inconvenience, cost, and silence between appointments.

A Different Audience With Different Needs

Women account for nearly 20% of new HIV diagnoses in the United States but represent a disproportionately small share of PrEP users. The disparity is not clinical. PrEP works the same regardless of sex. It is a marketing and outreach failure. PrEP was designed, studied, and promoted almost exclusively through the lens of gay and bisexual men. The infrastructure built around it followed suit.

Wisp, whose 1.8 million patients are predominantly women, is explicitly trying to change that. “We’re speaking to women differently than we would speak to the male community because it is a different audience with different needs,” Cepak says. “Being able to offer that at-home diagnostics is especially compelling for women managing children, households, and careers alongside their health.”

The go-to-market strategy includes partnerships with women influencers, in-person activations at Pride events in New York City, and messaging built around convenience and privacy rather than clinical prevention framing alone.

The clinical case for why this matters is unambiguous. "Women were left out of PrEP from the start," says Urbina. "The early trials and messaging centered on men who have sex with men, and that framing stuck, so clinicians often don't think to offer it to women and women don't know to ask." The consequences fall unevenly. "The gap falls hardest on Black and Latina women, who carry a disproportionate share of new HIV diagnoses, yet make up a small fraction of PrEP users."

Urbina argues the collaboration addresses the framing problem directly. "This collaboration meets women on a platform they already trust for their sexual and reproductive health, and lets them start and manage PrEP on their own time and in private. That reframes PrEP as a routine part of health care, and that is what closes the gap."

Build Versus Buy, And What Comes After PrEP

The Wisp-Mount Sinai collaboration did not happen organically. It was engineered.

In January 2026, Wisp acquired TBD Health, a company that brought diagnostic infrastructure, Epic integration capability, and existing hospital relationships. Five months later, the Mount Sinai partnership launched. "That was part of our strategy to accelerate B2B more broadly, and health system partnerships. By completing this acquisition, we were able to go to market faster versus building it ourselves from scratch," Cepak says.

That sequencing matters because it reveals the larger bet. Hospital systems across the country are facing a build-versus-buy decision on telehealth: invest in building digital infrastructure internally or partner with platforms already operating at scale.

Cepak sees the Mount Sinai collaboration as a proof of concept for the latter, and the use cases extend well beyond PrEP. "Reducing capacity in the emergency room for things like a UTI, a migraine, an outbreak of some sort, and being able to deliver that care through telemedicine, freeing up resources, reducing cost for hospital systems," she says, is the broader opportunity.

The pure direct-to-consumer telehealth model has real limits. Wisp is building something harder and, if it works, more durable: a hybrid layer that connects patients to clinical systems rather than competing with them. "Patients ultimately want a one-stop shop where they can get all of their healthcare needs in one place and feel like they're not jumping around from five different telehealth companies," Cepak says. "Connecting the dots efficiently—that is where I think the industry is ultimately moving."

From New York To A National Template

Launched during Pride Month, when federal HIV prevention funding faces serious political pressure, the Wisp-Mount Sinai collaboration carries an implicit argument: If public health infrastructure retreats, the private sector and academic medicine can step in—but only if they build the right architecture.

What separates this model from most digital health scaling is the community-based approach underneath it. "We don't just throw dollars at digital channels," Cepak says. "We put boots on the ground and really are embedded in the communities that we serve." Wisp will be activating at Pride events in New York City this month, with staff on the ground having one-on-one conversations. It is a deliberately human strategy for reaching communities that algorithms and ad spend alone cannot.

Cepak describes the New York program as "the beginning of a broader national template," with conversations already underway in other communities. The model needs to prove itself first—better retention numbers, measurable uptake in underserved populations, demonstrated value to Mount Sinai's system—before it travels. But the architecture is built for replication.

The drug has always worked. For the first time, the system delivering it might work too.