A Qualitative Systematic Literature Review of the Role of U.S. Pharmacists in Prescribing Pre-Exposure Prophylaxis (PrEP)

Abstract

Pre-Exposure Prophylaxis (PrEP) is an effective treatment to combat the human immunodeficiency virus (HIV) endemic, but the uptake of PrEP has been low in the United States (U.S.). While individuals may access PrEP via obtaining a prescription from their prescriber and having it dispensed by their pharmacist, less cumbersome access points may exist. This systematic literature review evaluates qualitative literature to explore the role of pharmacists, pharmacy services, and interprofessional collaborations for persons seeking PrEP in the United States. Four electronic databases (PubMed, Scopus, CINAHL, and Embase) were searched in February 2022 and yielded 3841 results. After excluding duplicates, two researchers reviewed 2461 studies. These results were screened for inclusion and exclusion criteria and yielded 71 studies for full review. Out of these 71 studies, five studies met the pre-selected inclusion criteria. Of the five studies, four were qualitative studies, and one was a mixed-methods study. The studies examined different aspects of initiating PrEP and diverse outcomes, such as screening for PrEP, barriers to access PrEP, feasibility to access PrEP, accessibility via community pharmacy to PrEP, and interdisciplinary collaboration between members of the healthcare team to expand patient access to PrEP. A gap in the qualitative literature focusing on U.S. pharmacists’ roles in initiation and provision of PrEP for diverse populations may exist. While PrEP promotion and uptake are largely affected by convenience and accessibility, future interventions and strategies should include training pertaining to PrEP screening, stigma reduction, privacy considerations, and PrEP dispensing.

Facilitators and barriers to community pharmacy PrEP delivery: a scoping review

“…If there was a lack of facilities, pharmacists reported that allowing clients to self‐test themselves for HIV [ 72 ] or having a collaborative service with other healthcare providers could help facilitate PrEP delivery, adherence and continuation [ 31 , 39 , 58 , 61 , 67 ]. Having a clear referral process for pharmacists to provide clients with the necessary treatment options for conditions identified during PrEP delivery was also found to facilitate PrEP delivery [ 73 ].…”

Facilitators and barriers to community pharmacy PrEP delivery: A scoping review

“…If there was a lack of facilities within the pharmacy, pharmacists reported that allowing clients to test themselves for HIV (65) or having a collaborative service with other health care providers could help facilitate PrEP delivery, adherence and continuation (28, 30, 42, 61, 62). Having a clear referral process for pharmacists to provide clients with the necessary treatment options for conditions identified during PrEP delivery was also found to facilitate PrEP delivery (35).…”

Overcoming structural barriers to diffusion of HIV pre-exposure prophylaxis

“…For example, partnerships with pharmacies have been effective in distributing vaccines for COVID-19, influenza, shingles, and other preventable diseases. Future studies of novel PrEP regimens could collaborate with pharmacies 74,75 during clinical trials to set up best practices in dissemination early on. Upon regulatory approval, these regimens could be rolled out without delay to those without clinical providers, insurance, or other access to PrEP.…”