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Development and implementation of a pharmacy PrEP awareness-raising and referral pathway: acceptability and feasibility of a UK pilot

China R Harrison*, Lindsey Harryman, Sarah Stockwell, Hannah E Family, Joanna Kesten, Sarah Denford, Jenny Scott, Caroline Sabin, Joanna Copping, John Saunders, Ross Hamilton-Shaw, Natalie Symonds, Osarenoma B. Dick, Emma Jane Tarmey, Jeremy Horwood

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

Abstract

Objectives:
To develop and pilot a community pharmacy pre-exposure prophylaxis (PrEP) awareness-raising and referral pathway, informed by a literature review and interviews with pharmacists and community members.

Methods:
Using the person-based approach and the Capability, Opportunity, Motivation-Behaviour change (COM-B) model, the pilot aimed to improve HIV/PrEP knowledge/capability and motivation through pharmacist and community awareness-raising. Opportunity was addressed by integrating PrEP consultations into pharmacy services and offering sexually transmitted infection (STI), HIV and kidney function home self-sampling kits. Financial incentives aimed at motivating pharmacists. Pharmacists initiated PrEP discussions and provided self-sampling kits. Individuals interested in starting PrEP were referred to the sexual health clinic, completed the tests and posted them to the clinic for processing. Clinic staff then confirmed PrEP eligibility and prescribed PrEP remotely. National Health Service (NHS) policy restrictions on pharmacies stocking NHS-procured PrEP informed the delivery model. The pilot evaluation focused on staff training impact, number/type of consultations and acceptability and feasibility for staff and community members.

Results:
The pilot was conducted in five pharmacies across Bristol, North Somerset and South Gloucestershire from October 2024 to April 2025. A total of 55 individuals (aged 18–69 years, n=23 male, n=31 female, n=1 transgender) were made aware of PrEP and offered a referral for PrEP. Visit reasons included emergency contraception (n=14), PrEP (n=14) and opioid substitution therapy (n=11). Twenty-eight community members expressed interest in PrEP; 22 accepted a self-sampling kit, nine returned it and four were prescribed PrEP. Pharmacists and community members viewed the service positively. Barriers included pharmacists’ initial lack of confidence initiating PrEP discussions and limited public awareness of PrEP availability in pharmacies.

Conclusion:
Community pharmacies represent a promising site for a PrEP awareness-raising and referral pathway. Successful scale-up requires pharmacist training, public health education and structural and policy changes to support accessible PrEP provision beyond sexual health clinics to reduce inequities.
Original languageEnglish
Number of pages7
JournalSexually Transmitted Infections
Early online date11 Feb 2026
DOIs
Publication statusE-pub ahead of print - 11 Feb 2026

Bibliographical note

Publisher Copyright:
© Author(s) (or their employer(s)) 2026.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

  1. SDG 3 - Good Health and Well-being
    SDG 3 Good Health and Well-being

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