Community pharmacy delivered PrEP to STOP HIV transmission: An opportunity NOT to miss!

López, María Isabel; Grant, Robert M.; Dong, Betty J.

doi:10.1016/j.japh.2020.01.026

Cited by 17 publications

(13 citation statements)

References 24 publications

(25 reference statements)

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“…This highlights the importance of culturally sensitive, and personalized service and confidentiality for PrEP clients. This is in contrast to some settings including the U.S. and Australia where “community pharmacy PrEP”has been made widely available and pharmacists play a key role in the national goals enhancing PrEP uptake and ending HIV endemic [ 30 , 31 ]. Endorsement and support of PrEP provision at community pharmacies are challenging and can be an important element to enhance HIV prevention efforts.…”

Section: Discussionmentioning

confidence: 98%

A comparison of attitudes and knowledge of pre-exposure prophylaxis (PrEP) between hospital and Key Population Led Health Service providers: Lessons for Thailand’s Universal Health Coverage implementation

et al. 2022

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Background HIV Pre-exposure prophylaxis (PrEP) has demonstrated efficacy and effectiveness among high-risk populations. In Thailand, PrEP has been included in the National Guidelines on HIV/AIDS Treatment and Prevention since 2014. As a part of the national monitoring and evaluation framework for Thailand’s universal coverage inclusion, this cross-sectional survey was conducted to assess knowledge of, attitudes to and practice (KAP) of PrEP service providers in Thailand. Methods We conducted a cross-sectional survey to explore knowledge of, and attitudes towards PrEP among providers from hospital and Key Population Led Health Services (KPLHS) settings. The questionnaire was distributed online in July 2020. Descriptive and univariate analysis using an independent-sample t-test were applied in the analyses. Attitudes were ranked from the most negative (score of 1) to the most positive (score of 5). Results Overall, there were 196 respondents (158 from hospitals and 38 from KPLHS) in which most hospital providers are female nurse practitioners while half of those from KPLHS report current gender as gay. Most respondents report a high level of PrEP knowledge and support provision in all high-risk groups with residual concern regarding anti-retroviral drugs resistance. Over two-fifths of providers from both settings perceive that PrEP would result in risk compensation and half of KPLHS providers are concerned regarding risk of sexual transmitted infections. Limited PrEP counselling time is a challenge for hospital providers. Conclusions Service integration between both settings, more involvement and distribution of KPLHS in reaching key populations would be essential in optimizing PrEP uptake and retention. Continuing support particularly in raising awareness about PrEP among healthcare providers and key populations, facilities and manpower, unlimited quota of patient recruitment and PrEP training to strengthen providers’ confidence and knowledge would be essential for successful PrEP implementation.

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Section: Discussionmentioning

confidence: 98%

A comparison of attitudes and knowledge of pre-exposure prophylaxis (PrEP) between hospital and Key Population Led Health Service providers: Lessons for Thailand’s Universal Health Coverage implementation

et al. 2022

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“…Where links with laboratories do not exist, it will be important to consider how they might be created to ensure appropriate support for PrEP initiation and continuation. 7 In some settings, health systems have developed simplified laboratory testing for PrEP delivery, for example, by waiving creatinine testing, or have allowed HIV self-testing for PrEP continuation. However, these models were found to be highly feasible with few adverse outcomes, warranting further research in a wider range of settings.…”

Section: Discussionmentioning

confidence: 99%

“…Pharmacies have been described as one area of untapped potential for PrEP delivery. [6][7][8] Pharmacies are often more accessible than health facilities, as they are usually conveniently located within communities, may have longer hours (including nights and weekends) and are available without an appointment. They also serve a wide range of health issues, so may reduce stigma associated with seeking HIV-related services.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

PrEP distribution in pharmacies: a systematic review

et al. 2022

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IntroductionNovel mechanisms of service delivery are needed to expand access to pre-exposure prophylaxis (PrEP) for HIV prevention. Providing PrEP directly through pharmacies could offer an additional option for reaching potential users.MethodsWe conducted a systematic review of studies examining effectiveness, values and preferences of end users and health workers, and cost of PrEP initiation and continuation through pharmacies (pharmacy access). We searched PubMed, CINAHL, LILACS and EMBASE through 2 December 2020. We also searched clinical trial registries and recent HIV conference abstracts. Standardised methods were used to search, screen and extract data from included studies.ResultsNo studies met the inclusion criteria for the effectiveness review, for either PrEP initiation or continuation. However, six ‘case studies’ presenting non-comparative data from PrEP pharmacy programmes demonstrated feasibility of this model in the USA. Eleven studies reported values and preferences of end users and health workers. In the USA, Kenya and South Africa, potential PrEP clients generally supported pharmacy access, although some preferred clinics. One study of PrEP pharmacy clients found all would ‘definitely recommend’ the programme. Six studies found pharmacists were generally supportive of offering PrEP; one study including doctors found more limited favour, while one study of diverse Kenyan stakeholders found broad support. Three studies reported cost data indicating client willingness to pay in the USA and Kenya and initial sustainability of a clinic financial model in the USA.ConclusionProvision of PrEP through pharmacies has been demonstrated to be feasible in the USA and acceptable to potential end users and stakeholders in multiple settings. Limited evidence on effectiveness and requirements for laboratory testing and assurance of high-quality services may limit enthusiasm for this approach. Further research is needed to determine if pharmacy access is a safe and effective way to help achieve global HIV prevention goals.PROSPERO registration numberCRD42021231650.

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“…Effective pharmacy-based PrEP interventions require that pharmacists be properly trained on PrEP prescription and adherence [ 35 , 78 , 80 , 87 , 88 , 91 , 97 ]. Funding related to the EHE initiative through the CDC HIV Prevention Capacity Building Assistance Program now has specific modules to train pharmacists and pharmacy leadership to integrate expanded communicable diseases testing with provision of PrEP.…”

Section: Discussionmentioning

confidence: 99%

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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Community pharmacy delivered PrEP to STOP HIV transmission: An opportunity NOT to miss!

Cited by 17 publications

References 24 publications

A comparison of attitudes and knowledge of pre-exposure prophylaxis (PrEP) between hospital and Key Population Led Health Service providers: Lessons for Thailand’s Universal Health Coverage implementation

A comparison of attitudes and knowledge of pre-exposure prophylaxis (PrEP) between hospital and Key Population Led Health Service providers: Lessons for Thailand’s Universal Health Coverage implementation

PrEP distribution in pharmacies: a systematic review

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

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