Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Behavioral, Social and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Curr HIV/AIDS Rep. 2024 Aug;21(4):197-207. doi: 10.1007/s11904-024-00700-5. Epub 2024 May 22.
Racial inequities in HIV in the United States (US) are pervasive. Pre-exposure prophylaxis (PrEP) is one of the most effective yet underutilized HIV prevention strategies, and stark inequities in PrEP uptake exist. Lack of access to PrEP clinics is a major barrier to access that could be overcome by integrating pharmacists into the provision of PrEP services including prescribing and dispensing.
A number of reviews have shown promise in folding pharmacies into the expansion of PrEP services, but this review extends those by examining the implementation science evidence of pharmacist-led PrEP services in the US. We reviewed literature over the past five years of the implementation science of pharmacist PrEP services (2018-2023) and present seminal findings in this area.
Only two studies are anchored within an implementation science framework despite all studies assessing common implementation science constructs. Overwhelming evidence supports feasibility and adoption of PrEP services in pharmacies yet gaps in workflow integration, scalability and sustainability exist.
Continuing to build the implementation science evidence of pharmacy-based PrEP services is critical to standardize our measures across varying contexts and inform policy efforts that support pharmacy-based PrEP services.
美国（US）的 HIV 存在严重的种族不平等现象。暴露前预防（PrEP）是最有效的 HIV 预防策略之一，但利用率却很低，而且在 PrEP 的使用上存在明显的不平等。缺乏获取 PrEP 诊所的机会是一个主要的障碍，可以通过将药剂师纳入 PrEP 服务的提供中（包括处方和配药）来克服。
许多评论表明，将药店纳入 PrEP 服务的扩大范围具有一定的前景，但这项评论通过检查美国药剂师主导的 PrEP 服务的实施科学证据，扩展了这些评论。我们回顾了过去五年中有关药剂师 PrEP 服务实施科学的文献（2018-2023 年），并介绍了该领域的重要发现。
尽管所有研究都评估了常见的实施科学结构，但只有两项研究基于实施科学框架。大量证据支持在药店提供 PrEP 服务的可行性和采用性，但在工作流程整合、可扩展性和可持续性方面仍存在差距。
继续建立基于药店的 PrEP 服务的实施科学证据对于在不同环境下标准化我们的措施以及为支持基于药店的 PrEP 服务的政策努力提供信息至关重要。
