Pharmacy-Based PrEP Program Can Increase HIV Prevention Services Among MSM

A pharmacy-based pre-exposure prophylaxis (PrEP) program can help expand HIV prevention care to men who have sex with men (MSM) in underserved areas, according to a new study published in the Journal of the American Pharmacists Association.¹

While many people in the United States live in health care deserts, most live within 5 miles of a community pharmacy, the researchers noted. This presents an opportunity for pharmacists to provide care that patients would otherwise not be able to access.

Pharmacists can help individuals living in rural areas access pre-exposure prophylaxis (PrEP) therapies. | image credit: Bowonpat - stock.adobe.com

The researchers wanted to develop a culturally appropriate, pharmacy-based PrEP delivery model that served the population of Black MSM who live in high poverty areas.

The study included participants from 2 pharmacies in low-income, underserved communities in the Atlanta, Georgia, area with high rates of HIV prevalence. Pharmacists and technicians deployed flyers and posters to advertise the study. Interested participants scanned a QR code to take a brief eligibility study; eligible participants then completed social and behavioral screenings. The researchers included participants who were male or transgender male who had sex with at least 1 man in the past 6 months, had unprotected receptive anal sex in the past 6 months, or had injected any drugs in the past 6 months. Participants were grouped by eligibility for PrEP due to sexual risk, injection drug risk, or both.

The researchers collected data on participants’ demographics, sex/drug use behaviors, health promoting behaviors, and willingness to participate in HIV prevention services.

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Out of 460 pharmacy clients screened, 81 (17.6%) were eligible for PrEP based on their sexual or drug injection behaviors. Out of the eligible participants, a majority were heterosexual (48.1%), white (58.0%), had a college degree or higher (70.4%). The researchers found that most participants were willing to receive free HIV testing in a pharmacy (90.1%), and 90.1% expressed comfort in being referred for HIV testing by a pharmacist.

Participants answered a series of questions about PrEP, and the awareness of PrEP (80.2%), interest in starting PrEP (80.2%), and lifetime PrEP use (64.2%) were high. A large majority (95.1%) of participants indicated that they were willing to screen for PrEP in a pharmacy, though these services are not yet available where the study took place.

Out of the participants indicated to receive PrEP, a majority were eligible due to sexual behaviors (58.0%), but many were eligible due to drug behaviors (27.2%) or a combination of both (14.8%). Between the groups, the researchers did not observe any difference in willingness to receive HIV prevention services from the pharmacy.

Among the 23 participants who had never taken PrEP, most cited that they did not know enough about it as the main reason (83%). This was followed by concern about side effects (26%) and not knowing where to obtain PrEP (22%).

While previous studies have looked at the feasibility of pharmacy-based HIV prevention services, this study does so without targeted intervention and recruitment.

“Willingness to obtain HIV prevention services among populations at increased risk for HIV was high, indicating that pharmacies have strong promise for addressing inequities in HIV, including access barriers and, ultimately, disease burden,” said the researchers.

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Reference

1. Crawford ND, Harrington KRV, Chandra C, et al. Feasibility of reaching populations at high risk for HIV in community pharmacies. J Am Pharm Assoc. 2024. doi:10..1016/j.japh.2024.102239.