Pharmacy-based pre-exposure prophylaxis support among pharmacists and men who have sex with men

Crawford, Natalie D.; Josma, Dorie; Morris, Joseph; Hopkins, Roderick; Young, Henry N.

doi:10.1016/j.japh.2019.12.003

Cited by 26 publications

(43 citation statements)

References 27 publications

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“…Kenyan stakeholders found the concept of pharmacy PrEP delivery to be acceptable and conditioned their acceptance on assurances that care would be private, respectful, safe, and affordable. Similar to their counterparts in highincome settings [33][34][35], pharmacy and PrEP providers in our study were open to task-shifting PrEP delivery to retail pharmacy providers, though did identify factors that could reduce the feasibility of pharmacy-based PrEP delivery (e.g., insufficient provider time). Overall, most participants considered retail pharmacies an ideal venue for reaching individuals at HIV risk who are unable or unwilling to obtain PrEP at public clinics.…”

Section: Discussionmentioning

confidence: 97%

Acceptability and Feasibility of Pharmacy-Based Delivery of Pre-Exposure Prophylaxis in Kenya: A Qualitative Study of Client and Provider Perspectives

et al. 2021

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As countries scale up pre-exposure prophylaxis (PrEP) for HIV prevention, diverse PrEP delivery models are needed to expand access to populations at HIV risk that are unwilling or unable to access clinic-based PrEP care. To identify factors that may influence implementation of retail pharmacy-based PrEP delivery in Kenya, we conducted in-depth interviews with 40 pharmacy clients, 16 pharmacy providers, 16 PrEP clients, and 10 PrEP providers from two provinces. Most participants expressed strong support for expanding PrEP to retail pharmacies, though conditioned their acceptance on assurances that care would be private, respectful, safe, and affordable. Participant-reported determinants of feasibility centered primarily on ensuring that the intervention is compatible with retail pharmacy operations (e.g., staffing levels, documentation requirements). Future research is needed to develop and test tailored packages of implementation strategies that are most effective at integrating PrEP delivery into routine pharmacy practice in Kenya and other high HIV prevalence settings.

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Section: Discussionmentioning

confidence: 97%

Acceptability and Feasibility of Pharmacy-Based Delivery of Pre-Exposure Prophylaxis in Kenya: A Qualitative Study of Client and Provider Perspectives

et al. 2021

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“…The sample size of such studies ranged from 9 [ 44 ] to 7148 [ 45 ]. Fourteen studies contained primary observational data concerning practicing pharmacists’ and Doctor of Pharmacy (PharmD) students’ knowledge, perceptions, and attitudes of pharmacy-based PrEP interventions [ 44 , 46 – 55 ]. Pharmacists and/or pharmacy students from all four of the U.S. Census Bureau regions were represented.…”

Section: Resultsmentioning

confidence: 99%

“…Eleven studies contained data concerning patient experiences with or attitudes toward PrEP pickup or prescription in pharmacies [ 45 , 46 , 59 – 67 ]. Ten of these studies targeted patients of high-risk populations, such as people who inject drugs and MSM, who were seeking to initiate PrEP.…”

Section: Resultsmentioning

confidence: 99%

“…Ten of these studies targeted patients of high-risk populations, such as people who inject drugs and MSM, who were seeking to initiate PrEP. Reported barriers among these populations concerning PrEP delivery in pharmacies included a lack of medication availability, difficulty with mail refills, misinformation about medication cost, and privacy concerns [ 45 , 46 , 59 – 62 , 64 – 67 ]. Two other studies targeted broader populations to collect general patient perspectives on the prescriptive authority of pharmacists.…”

Section: Resultsmentioning

confidence: 99%

“…Two other studies targeted broader populations to collect general patient perspectives on the prescriptive authority of pharmacists. The first was a qualitative study, which examined the perceptions of PrEP delivery in pharmacies among MSM residing in Atlanta who were not necessarily interested in initiating PrEP [ 46 ]. Patients expressed strong support for future PrEP prescription and screening.…”

Section: Resultsmentioning

confidence: 99%

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Pharmacy-Based Interventions to Increase Use of HIV Pre-exposure Prophylaxis in the United States: A Scoping Review

et al. 2021

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HIV pre-exposure prophylaxis (PrEP) remains underutilized in the U.S. Since greater than 85% of PrEP prescriptions are filled at commercial pharmacies, pharmacists are uniquely positioned to increase PrEP use. This scoping review explores pharmacy-based initiatives to increase PrEP use. We searched PubMed, PsycINFO, CINAHL, and Scopus for peer-reviewed studies on pharmacist-led interventions to increase PrEP use or pharmacy-based PrEP initiatives. Forty-nine articles were included in this review. Overall, studies demonstrated that patients expressed strong support for pharmacist prescription of PrEP. Three intervention designs compared changes in PrEP initiation or knowledge pre- and post-intervention. Commentary/review studies recommended PrEP training for pharmacists, policy changes to support pharmacist screening for HIV and PrEP prescription, and telemedicine to increase prescriptions. Pharmacists could play key roles in improving PrEP use in the U.S. Studies that assess improvements in PrEP use after interventions such as PrEP prescription, PrEP-specific training, and adherence monitoring by pharmacists are needed.

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

Harrison,

Family,

Kesten

et al. 2024

J Int AIDS Soc.

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IntroductionPre‐exposure prophylaxis (PrEP) is an effective medication to reduce the risk of acquiring HIV. PrEP is available free of charge in the UK from sexual health clinics. Expanding PrEP delivery to community pharmacies holds promise and aligns with UK government goals to eliminate new cases of HIV by 2030. The aim of this scoping review was to describe the existing evidence about the barriers to and facilitators of community pharmacy oral PrEP delivery, for pharmacists and pharmacy clients, as aligned with the Capacity Opportunity, Motivation Behaviour (COM‐B) Model.MethodsFive bibliographic and five review databases were searched from inception to August 2023. Literature of any study design was included if it discussed barriers and facilitators of community pharmacy PrEP delivery. Trial registrations, protocols and news articles were excluded.ResultsA total of 649 records were identified, 73 full texts were reviewed and 56 met the inclusion criteria, predominantly from high‐income/westernized settings. Most of the included literature was original research (55%), from the United States (77%) conducted during or after the year 2020 (63%). Barriers to PrEP delivery for pharmacists included lack of knowledge, training and skills (capability), not having the necessary facilities (opportunity), concern about the costs of PrEP and believing that PrEP use could lead to risk behaviours and sexually transmitted infections (motivation). Facilitators included staff training (capability), time, the right facilities (opportunity), believing PrEP could be a source of profit and could reduce new HIV acquisitions (motivation). For clients, barriers included a lack of PrEP awareness (capability), pharmacy facilities (opportunity) and not considering pharmacists as healthcare providers (motivation). Facilitators included awareness of PrEP and pharmacist's training to deliver it (capability), the accessibility of pharmacies (opportunity) and having an interest in PrEP (motivation).DiscussionTo effectively enhance oral PrEP delivery in UK community pharmacies, the identified barriers and facilitators should be explored for UK relevance, addressed and leveraged at the pharmacy team, client and care pathway level.ConclusionsBy comprehensively considering all aspects of the COM‐B framework, community pharmacies could become crucial providers in expanding PrEP accessibility, contributing significantly to HIV prevention efforts.

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Pharmacy-based pre-exposure prophylaxis support among pharmacists and men who have sex with men

Cited by 26 publications

References 27 publications

Acceptability and Feasibility of Pharmacy-Based Delivery of Pre-Exposure Prophylaxis in Kenya: A Qualitative Study of Client and Provider Perspectives

Acceptability and Feasibility of Pharmacy-Based Delivery of Pre-Exposure Prophylaxis in Kenya: A Qualitative Study of Client and Provider Perspectives

Pharmacy-Based Interventions to Increase Use of HIV Pre-exposure Prophylaxis in the United States: A Scoping Review

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

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