Influencing Factors for the Acceptability of Accessing HIV Pre‐exposure Prophylaxis via Community Pharmacies in Wales

INTRODUCTION: HIV prevention methods, such as pre-exposure prophylaxis (PrEP), have been a significant contributing factor to a global decline in HIV transmission. PrEP has been available through the NHS in Wales since 2017. However, access is exclusively via sexual health clinics, and those accessing PrEP do not reflect those being diagnosed with HIV. Widening access beyond sexual health clinics may be one approach to encourage more equitable uptake, and there is growing interest in offering PrEP services in community pharmacies. We, therefore, aimed to explore the acceptability of PrEP services being delivered through community pharmacies among prospective service users. METHODS: We conducted a qualitative interview study of people living in Wales who either (i) currently access, (ii) previously accessed or are (iii) considering accessing PrEP via a sexual health clinic. Participants were recruited via community networks, and interviews were conducted virtually. Our topic guide was informed by Levesque's conceptual framework of access to healthcare, and we used reflexive thematic analysis. RESULTS: We interviewed 24 participants and included data from 20 in the analysis. Four themes were generated: experiences of accessing PrEP via sexual health clinics, the prospect of PrEP access via community pharmacies, other community settings in which PrEP may be accessed and concerns around integrated healthcare and healthcare data. CONCLUSION: PrEP access via community pharmacy is likely to be an acceptable option for people. There are uncertainties surrounding what a PrEP service would look like in a community pharmacy setting, and this would need clarifying to prospective users to increase the salience of access. PATIENT AND PUBLIC CONTRIBUTION: A team-based approach was taken for developing the topic guide and agreeing on the codes for this study. This included people with lived experience of accessing PrEP in Wales

Environmental health · Family medicine · Health care · Men who have sex with men · Political science · Population · Pre-exposure prophylaxis · Qualitative research · Reproductive health · Sexual health clinic · Sociology · Thematic analysis · HIV, Drug Use, Sexual Risk · HIV/AIDS Research and Interventions · Medicine · Nursing · Sex work and related issues · Pharmacy

• Efficacy, safety, and effect on sexual behaviour of on-demand pre-exposure prophylaxis for HIV in men who have sex with men

  Open Access•Jean‐michel Molina, Jean-Michel Molina et al.•The Lancet HIV•2017

  Incluir item

• Antiretroviral prophylaxis for HIV infection in injecting drug users in Bangkok, Thailand (the Bangkok Tenofovir Study)

  Kachit Choopanya, Michael E Martins et al.•The Lancet•2013

  Incluir item

• Pre-exposure prophylaxis to prevent the acquisition of HIV-1 infection (PROUD)

  Open Access•Sheena McCormack, D Dunn et al.•The Lancet•2016

  Incluir item

• Preexposure Chemoprophylaxis for HIV Prevention in Men Who Have Sex with Men

  Robert M Grant, Javier R Lama et al.•New England Journal of Medicine•2010

  Incluir item

• Patient-centred access to health care

  Open Access•Jean-Frédéric Levesque, Mark F Harris et al.•International Journal for Equity…•2013

  Incluir item

• The behaviour change wheel

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

  Incluir item

• Reflecting on reflexive thematic analysis

  Braun, Virginia Braun et al.•Qualitative Research in Sport and…•2019

  Incluir item

• ‘Imposter participants’ in online qualitative research, a new and increasing threat to data integrity

  Open Access•Damien Ridge, Laurna Bullock et al.•Health Expectations•2023

  Incluir item

• Sample Size in Qualitative Interview Studies

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

  Incluir item