TY - JOUR

T1 - Influencing Factors for the Acceptability of Accessing HIV Pre-exposure Prophylaxis via Community Pharmacies in Wales

AU - Gillespie, David

AU - Williams, Adam D N

AU - Ma, Richard

AU - Couzens, Zoe

AU - Hood, Kerenza

AU - Hughes, Dyfrig A

AU - Mantzourani, Efi

AU - Cochrane, Eleanor

AU - Wood, Fiona

N1 - © 2025 The Author(s). Health Expectations published by John Wiley & Sons Ltd.

PY - 2025/4/10

Y1 - 2025/4/10

N2 - 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.

AB - 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.

KW - Humans

KW - Wales

KW - Pre-Exposure Prophylaxis

KW - Male

KW - HIV Infections/prevention & control

KW - Female

KW - Adult

KW - Qualitative Research

KW - Patient Acceptance of Health Care/psychology

KW - Health Services Accessibility

KW - Middle Aged

KW - Interviews as Topic

KW - Community Pharmacy Services

KW - Anti-HIV Agents/therapeutic use

U2 - 10.1111/hex.70247

DO - 10.1111/hex.70247

M3 - Article

C2 - 40181658

VL - 28

SP - e70247

JO - Health Expectations

JF - Health Expectations

SN - 1369-6513

IS - 2

ER -