Implementing long-acting injectable HIV pre-exposure prophylaxis services at private pharmacies in Kenya

INTRODUCTION: Maximising the impact of new and forthcoming long-acting injectable HIV pre-exposure prophylaxis (PrEP) products will require novel delivery approaches that widen accessibility and prioritise clients' needs and preferences. To understand the potential barriers and facilitators to delivering injectable PrEP via private pharmacies in Kenya, we conducted qualitative formative research. METHODS: From July to September 2023, we interviewed pharmacy providers, pharmacy clients and other key stakeholders of HIV service delivery in Central and Western Kenya. Our purposive sample included some providers and clients with prior experience delivering or obtaining oral PrEP at a pharmacy as part of a pilot study and some without such experience. We analysed verbatim transcripts thematically using a combination of inductive and deductive approaches, the latter informed by the Consolidated Framework for Implementation Research. RESULTS: We interviewed 25 pharmacy clients, 16 pharmacy providers and nine key stakeholders. Each group was ~50% female, and median age among clients was 25 (IQR 23-29). Overall, participants supported the idea of pharmacy-based injectable PrEP delivery. Anticipated facilitators included perceived benefits of injectable over oral PrEP; characteristics of pharmacies (eg, long operating hours) that could fulfil clients' need for accessible, fast and private injectable PrEP services; and existing skillsets of pharmacy providers, especially those already trained on injectable contraception. Anticipated barriers included gaps in enabling policy; pharmacies' lack of integration with the public health sector, such as its health information system; low client knowledge of and/or ability to pay for injectable PrEP and pharmacy staffing and compensation structures that could disincentivise providers. CONCLUSIONS: Participants in this study expressed cautious optimism that private pharmacies could be an effective delivery channel for injectable PrEP in Kenya. If private pharmacies facilitate access to and use of injectable PrEP, they could play a pivotal role in ending HIV as a public health threat

Health care · Optimism · Private sector · Public health · Stakeholder · Global Maternal and Child Health · HIV, Drug Use, Sexual Risk · HIV/AIDS Research and Interventions · Pharmacy

• Using the Consolidated Framework for Implementation Research (CFIR) to produce actionable findings

  Open Access•Rosalind E Keith, Jesse C Crosson et al.•Implementation Science•2017

  Añadir item

• The behaviour change wheel

  Open Access•Susan Michie, Maartje M Van Stralen et al.•Implementation Science•2011

  Añadir item

• Characterising the HIV self-testing market in Kenya

  Open Access•Rebecca West, Lily Freeman et al.•PLOS Global Public Health•2023

  Añadir item

• Facilitators and barriers to HIV pre-exposure prophylaxis (PrEP) uptake through a community-based intervention strategy among adolescent girls and young women in Seme Sub-County, Kisumu, Kenya

  Open Access•Maya Jackson-Gibson, Ashley Ezema et al.•BMC Public Health•2021

  Añadir item

• Acceptability and Feasibility of Pharmacy-Based Delivery of Pre-Exposure Prophylaxis in Kenya

  Open Access•Stephanie Roche, Njeri Wairimu et al.•AIDS and Behavior•2021

  Añadir item

• Sample Size in Qualitative Interview Studies

  Open Access•Kirsti Malterud, Volkert Dirk Siersma et al.•Qualitative Health Research•2016

  Añadir item