University of Washington Developmental AIDS Research Center for Mental Health (UW ARCH)

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Project Summary/Abstract Despite availability of HIV pre-exposure prophylaxis (PrEP) for over a decade, many persons who could benefit from PrEP have not yet accessed PrEP services. Implementation of pharmacy-based PrEP is a promising strategy that presents opportunity to overcome barriers related to clinic distance and stigma and to increase PrEP access, uptake, persistence, and adherence among individuals who would benefit most. Despite the fact that project team member and pharmacist Dr. Elyse Tung started the first pharmacy-based PrEP clinic in Seattle nearly ten years ago, PrEP still is not widely available through pharmacies without a prescription from a licensed doctor or other clinician. As of 2023, not all states allow pharmacists to prescribe and dispense PrEP without a doctor’s prescription, and many insurance companies erect barriers to providing compensation to pharmacists for this role. Work is needed to develop and refine the training and educational support specifically required by pharmacists to expand their scope of practice and to advocate for supportive policies. This administrative supplement application to the Ending the HIV Epidemic (EHE) initiative proposes two specific aims. Aim 1 will establish an online virtual community of practice (VCoP) for pharmacists and pharmacy staff to increase their knowledge, capabilities, and comfort in prescribing PrEP. The second aim will outline a comprehensive PrEP curriculum for pharmacists, technicians, and students. Ultimately, the goal of this supplement is to support sustainable pharmacy-based programs that will increase the number of people starting and continuing PrEP in EHE jurisdictions across the United States. This project addresses the Prevent pillar of the EHE plan with a secondary impact on the Diagnose pillar. This project also addresses the NIH HIV/AIDS Research Priorities (NOT-OD-20-018) to reduce HIV incidence by testing new prevention strategies and training the HIV workforce. It is in synergy with the local EHE plan (see Letter of Support from Ms. Hutcheson, EHE Program Manager), the Washington State Department of Health (see Letter of Support), and the National HIV/AIDS Strategy. The national strategy specifically calls out to leverage pharmacists’ knowledge and accessibility in nearly every urban and rural community as part of a comprehensive HIV prevention and care strategy. Ultimately our goal is to provide more PrEP options and expand access points for PrEP care in locations and to populations disproportionately impacted by HIV infection.in order to end the HIV epidemic.