{
  "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.",
  "authors": [
    {
      "affiliations": [
        "National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West), Bristol, UK",
        "National Institute for Health and Care Research, Health Protection Research Unit (HPRU) in Evaluation and Behavioural Science (EBS), Bristol, UK",
        "Population Health Sciences, University of Bristol, Bristol, UK"
      ],
      "name": "China Harrison"
    },
    {
      "affiliations": [
        "University Hospitals Bristol and Weston (UHBW), NHS Foundation Trust, Bristol, UK"
      ],
      "name": "Lindsey Harryman"
    },
    {
      "affiliations": [
        "Department of Sexual Health, Cardiff Royal Infirmary, Cardiff, UK"
      ],
      "name": "Sarah Stockwell"
    },
    {
      "affiliations": [
        "National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West), Bristol, UK",
        "National Institute for Health and Care Research, Health Protection Research Unit (HPRU) in Evaluation and Behavioural Science (EBS), Bristol, UK",
        "Population Health Sciences, University of Bristol, Bristol, UK"
      ],
      "name": "Hannah Family"
    },
    {
      "affiliations": [
        "National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West), Bristol, UK",
        "National Institute for Health and Care Research, Health Protection Research Unit (HPRU) in Evaluation and Behavioural Science (EBS), Bristol, UK",
        "Population Health Sciences, University of Bristol, Bristol, UK"
      ],
      "name": "Joanna May Kesten"
    },
    {
      "affiliations": [
        "National Institute for Health and Care Research, Health Protection Research Unit (HPRU) in Evaluation and Behavioural Science (EBS), Bristol, UK",
        "Population Health Sciences, University of Bristol, Bristol, UK"
      ],
      "name": "Sarah Denford"
    },
    {
      "affiliations": [
        "Population Health Sciences, University of Bristol, Bristol, UK"
      ],
      "name": "Jennifer Scott"
    },
    {
      "affiliations": [
        "Institute for Global Health, UCL, London, UK",
        "National Institute for Health and Care Research (NIHR) Health Protection Research Unit (HPRU) in Blood-Borne and Sexually Transmitted Infections, University College London, London, UK"
      ],
      "name": "Caroline Sabin"
    },
    {
      "affiliations": [
        "Communities and Public Health, Bristol City Council, Bristol, UK"
      ],
      "name": "Joanna Copping"
    },
    {
      "affiliations": [
        "Institute for Global Health, UCL, London, UK",
        "Blood Safety, Hepatitis, STI & HIV Division, UK Health Security Agency, London, UK"
      ],
      "name": "John Saunders"
    },
    {
      "affiliations": [
        "Gilead Sciences Ltd, London, UK"
      ],
      "name": "Ross Hamilton-Shaw"
    },
    {
      "affiliations": [
        "Public Health and Wellbeing, South Gloucestershire Council, South Gloucestershire, UK"
      ],
      "name": "Natalie Symonds"
    },
    {
      "affiliations": [
        "Patient and Public Involvement Collaborator, Bristol, UK"
      ],
      "name": "Osarenoma B Dick"
    },
    {
      "affiliations": [
        "Patient and Public Involvement Contributor, Bristol, UK"
      ],
      "name": "Emma Tarmey"
    },
    {
      "affiliations": [
        "National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West), Bristol, UK",
        "National Institute for Health and Care Research, Health Protection Research Unit (HPRU) in Evaluation and Behavioural Science (EBS), Bristol, UK",
        "Population Health Sciences, University of Bristol, Bristol, UK"
      ],
      "name": "Jeremy Horwood"
    }
  ],
  "title": "Development and implementation of a pharmacy PrEP awareness-raising and referral pathway: acceptability and feasibility of a UK pilot",
  "uid": "91f0b6fc-fe1f-5759-9708-8bbab7aa5609"
}