J Int AIDS Soc
National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West), Bristol, UK.
Published: March 2024
Introduction: Pre-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.
Methods: Five 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.
Results: A 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).
Discussion: To 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.
Conclusions: By 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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http://dx.doi.org/10.1002/jia2.26232 | DOI Listing |
AIDS Behav
January 2025
Wits RHI, University of Witwatersrand, Johannesburg, South Africa.
In South Africa, oral PrEP was included in national guidelines as part of a combination HIV prevention package for adolescent girls and young women (AGYW) in 2017. Understanding their experiences of accessing and using PrEP is necessary to evaluate and improve PrEP service delivery approaches. This descriptive study explored AGYW's knowledge and understanding of PrEP, their experiences and influences on PrEP access and use in real world settings in South Africa.
View Article and Find Full Text PDFPLoS One
January 2025
Duke Global Health Institute, Duke University, Durham, NC, United States of America.
Introduction: HIV poses a significant global health concern, affecting adolescents among other populations. This is attributed to various vulnerabilities including biological factors, gender inequalities and limited access to comprehensive sexual and reproductive health services in sub-Saharan Africa. In Tanzania, adolescent girls, and young women (AGYW) face double the risk of HIV infection compared to their male counterparts.
View Article and Find Full Text PDFEClinicalMedicine
December 2024
University of North Carolina Project-China, Guangzhou, China.
Background: Adolescents (10-19 years old) have poor outcomes across the prevention-to-treatment HIV care continuum, leading to significant mortality and morbidity. We conducted a systematic review and meta-analysis of interventions that documented HIV outcomes among adolescents in HIV high-burden countries.
Methods: We searched PubMed, EMBASE, Scopus, and the Cochrane Library for studies published between January 2015 and September 2024, assessing at least one HIV outcome along the prevention-to-care cascade, including PrEP uptake, HIV testing, awareness of HIV infections, ARV adherence, retention, and virological suppression.
Curr HIV/AIDS Rep
January 2025
School of Nursing and Health Studies, University of Miami, 5030 Brunson Dr, Coral Gables, Miami, FL, 33146, USA.
Purpose Of Review: Latino/x/e men who have sex with men (LMSM) in the United States are disproportionately affected by HIV. Peer-led adjunctive interventions show promise for enhancing engagement in HIV prevention and care among LMSM, but their effectiveness and implementation remain underexplored. This scoping review aimed to map existing evidence on peer-led interventions, identify gaps, and inform future research for enhancing HIV prevention and care among LMSM.
View Article and Find Full Text PDFAIDS Patient Care STDS
January 2025
Section of Infectious Diseases, Yale School of Medicine, New Haven, Connecticut, USA.
Low engagement with HIV services persists among young men with harmful alcohol use in South Africa. We previously piloted a rural community-based HIV service delivery model to engage this key population. In the initial study, male nurses visited alcohol-serving venues to provide HIV testing and pre-exposure prophylaxis (PrEP) services.
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