{"doi":"10.1002/jia2.26467","title":"A modified pharmacy provider‐led delivery model of oral HIV pre‐ and post‐exposure prophylaxis in Kenya: a pilot study extension","abstract":"<jats:title>Abstract</jats:title><jats:sec><jats:title>Introduction</jats:title><jats:p>Private pharmacies in Africa reach individuals with ongoing and periodic HIV risk, yet few countries currently leverage pharmacies as an HIV service delivery platform. We conducted a 6‐month pilot to evaluate a model for pharmacy provider‐led delivery of HIV pre‐ and post‐exposure prophylaxis (PrEP and PEP) in Kenya.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>At 12 private pharmacies in Kisumu and Kiambu Counties, licensed pharmacy providers initiated and managed eligible clients ≥18 years on PrEP and PEP under remote clinician supervision (NCT04558554); four of these pharmacies additionally offered sextually transmitted infection (STI) testing. PrEP/PEP clients were scheduled for follow‐up 1 month later and then quarterly (PrEP clients only). Primary outcomes included PrEP and PEP initiation and continuation during the pilot period. Client and providers rated the model across multiple constructs of acceptability and feasibility from established frameworks.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>From January to July 2022, 1028 clients interested in PrEP, PEP and/or STI testing were screened and 829 initiated one or more service: 661 PrEP, 162 PEP and 52 STI testing. About half of clients (48%, 398/829) were male, most were unmarried (78%, 644/829) and PrEP‐naïve (89%, 737/829), and the median age was 25 years (IQR 22–31). Most PrEP clients reported inconsistent condom use (88%, 581/661) or sex with partners of unknown HIV status (70%, 460/661) in the past 6 months. Most PEP clients reported condomless sex (48%, 78/162) or a condom break (46%, 75/162) in the past 72 hours; 4% (6/162) reported sexual assault. Among PrEP clients eligible for a refill, 73% (479/658) refilled at least once and 60% (197/328) twice. Among PEP clients eligible for follow‐up, 44% (65/148) completed follow‐up HIV testing and 20% (30/148) transitioned to PrEP. Among STI clients, 19% (10/52) tested positive for gonorrhoea (<jats:italic>n</jats:italic> = 7) and/or chlamydia (<jats:italic>n</jats:italic> = 5). Most clients and providers (≥92%) found the delivery model and its implementation strategies acceptable. All providers (<jats:italic>n</jats:italic> = 12) thought it was possible to deliver PrEP and PEP at pharmacies in Kenya.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Pharmacy PrEP/PEP delivery achieved high uptake, continuation and acceptability among eligible clients that could benefit, highlighting the potential of pharmacies to expand HIV prevention service coverage in Kenya, particularly to individuals not accessing these services at clinics.</jats:p></jats:sec>","journal":"Journal of the International AIDS Society","year":2025,"id":608643,"datarank":0.29188652235829704,"base_score":1.9459101490553132,"endowment":1.9459101490553132,"self_citation_contribution":0.29188652235829704,"citation_network_contribution":0.0,"self_endowment_contribution":0.29188652235829704,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":6,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":674057,"name":"Victor Omollo","orcid":"0009-0002-4013-492X","position":1,"is_corresponding":false},{"id":338967,"name":"Peter Mogere","orcid":"0000-0003-0465-5760","position":2,"is_corresponding":false},{"id":1563427,"name":"Magdaline Asewe","orcid":null,"position":3,"is_corresponding":false},{"id":1093660,"name":"Stephen Gakuo","orcid":null,"position":4,"is_corresponding":false},{"id":1452354,"name":"Preetika Banerjee","orcid":null,"position":5,"is_corresponding":false},{"id":1563428,"name":"Kendall Harkey","orcid":null,"position":6,"is_corresponding":false},{"id":289068,"name":"Monisha Sharma","orcid":"0000-0002-7599-1561","position":7,"is_corresponding":false},{"id":299045,"name":"Jillian Pintye","orcid":"0000-0003-1255-7191","position":8,"is_corresponding":false},{"id":572942,"name":"Melissa Latigo Mugambi","orcid":"0000-0001-8875-5528","position":9,"is_corresponding":false},{"id":762044,"name":"Parth Shah","orcid":"0000-0001-5125-9627","position":10,"is_corresponding":false},{"id":505087,"name":"Josephine Odoyo","orcid":"0000-0003-1749-8645","position":11,"is_corresponding":false},{"id":1563429,"name":"Patricia Ong'wen","orcid":null,"position":12,"is_corresponding":false},{"id":1563430,"name":"Daniel Were","orcid":"0000-0002-6538-002X","position":13,"is_corresponding":false},{"id":255294,"name":"Elizabeth A. Bukusi","orcid":"0000-0002-2031-2808","position":14,"is_corresponding":false},{"id":331198,"name":"Kenneth Ngure","orcid":"0000-0002-8062-0933","position":15,"is_corresponding":false},{"id":338966,"name":"Katrina F. Ortblad","orcid":"0000-0002-5675-8836","position":16,"is_corresponding":false},{"id":674055,"name":"Stephanie D. Roche","orcid":"0000-0001-7569-3241","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"A modified pharmacy provider‐led delivery model of oral HIV pre‐ and post‐exposure prophylaxis in Kenya: a pilot study extension","abstract":"<jats:title>Abstract</jats:title><jats:sec><jats:title>Introduction</jats:title><jats:p>Private pharmacies in Africa reach individuals with ongoing and periodic HIV risk, yet few countries currently leverage pharmacies as an HIV service delivery platform. We conducted a 6‐month pilot to evaluate a model for pharmacy provider‐led delivery of HIV pre‐ and post‐exposure prophylaxis (PrEP and PEP) in Kenya.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>At 12 private pharmacies in Kisumu and Kiambu Counties, licensed pharmacy providers initiated and managed eligible clients ≥18 years on PrEP and PEP under remote clinician supervision (NCT04558554); four of these pharmacies additionally offered sextually transmitted infection (STI) testing. PrEP/PEP clients were scheduled for follow‐up 1 month later and then quarterly (PrEP clients only). Primary outcomes included PrEP and PEP initiation and continuation during the pilot period. Client and providers rated the model across multiple constructs of acceptability and feasibility from established frameworks.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>From January to July 2022, 1028 clients interested in PrEP, PEP and/or STI testing were screened and 829 initiated one or more service: 661 PrEP, 162 PEP and 52 STI testing. About half of clients (48%, 398/829) were male, most were unmarried (78%, 644/829) and PrEP‐naïve (89%, 737/829), and the median age was 25 years (IQR 22–31). Most PrEP clients reported inconsistent condom use (88%, 581/661) or sex with partners of unknown HIV status (70%, 460/661) in the past 6 months. Most PEP clients reported condomless sex (48%, 78/162) or a condom break (46%, 75/162) in the past 72 hours; 4% (6/162) reported sexual assault. Among PrEP clients eligible for a refill, 73% (479/658) refilled at least once and 60% (197/328) twice. Among PEP clients eligible for follow‐up, 44% (65/148) completed follow‐up HIV testing and 20% (30/148) transitioned to PrEP. Among STI clients, 19% (10/52) tested positive for gonorrhoea (<jats:italic>n</jats:italic> = 7) and/or chlamydia (<jats:italic>n</jats:italic> = 5). Most clients and providers (≥92%) found the delivery model and its implementation strategies acceptable. All providers (<jats:italic>n</jats:italic> = 12) thought it was possible to deliver PrEP and PEP at pharmacies in Kenya.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Pharmacy PrEP/PEP delivery achieved high uptake, continuation and acceptability among eligible clients that could benefit, highlighting the potential of pharmacies to expand HIV prevention service coverage in Kenya, particularly to individuals not accessing these services at clinics.</jats:p></jats:sec>","is_dataset_classified":null,"base_score":1.791759469228055,"endowment":1.791759469228055,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"40569884","pmcid":"PMC12231645","openalex_id":"https://openalex.org/W4411674688","authors":[],"funders":[{"funder_name":"Bill and Melinda Gates Foundation","grant_id":"INV‐033052","title":null},{"funder_name":"National Institute of Mental Health","grant_id":"R34 MH120106","title":null},{"funder_name":"National Institute of Mental Health","grant_id":"R00MH121166","title":null},{"funder_name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","grant_id":"R01HD108041","title":null},{"funder_name":"Gates Foundation","grant_id":"INV-033052","title":null},{"funder_name":"National Institutes of Health","grant_id":"1R34MH120106-01A1","title":"Pharmacy delivery to expand the reach of PrEP in Kenya"},{"funder_name":"National Institutes of Health","grant_id":"5R01HD108041-05","title":"Enhancing PrEP outcomes among Kenyan adolescent girls and young women with a novel pharmacy-based PrEP delivery platform"},{"funder_name":"National Institutes of Health","grant_id":"3R00MH121166-06S1","title":"Peer PrEP referral + HIV self-test for PrEP initiation among young Kenyan women"}],"total_grants":8,"fwci":4.1205,"citation_percentile":0.94274859,"influential_citations":0,"citation_trend":[{"year":2025,"count":4},{"year":2026,"count":1}],"oa_status":"gold","license":"cc-by","oa_locations":[{"url":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/jia2.26467","host_type":"journal"},{"url":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/jia2.26467","host_type":"publisher"},{"url":"https://onlinelibrary.wiley.com/doi/pdf/10.1002/jia2.26467","host_type":"publisher"},{"url":"https://doi.org/10.1002/jia2.26467","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/40569884","host_type":"repository"},{"url":"https://doaj.org/article/cf5645d9332841228c37bf2fab761748","host_type":"repository"},{"url":"https://www.ncbi.nlm.nih.gov/pmc/articles/12231645","host_type":"repository"},{"url":"https://europepmc.org/articles/PMC12231645","host_type":"Europe_PMC"},{"url":"https://europepmc.org/articles/PMC12231645?pdf=render","host_type":"Europe_PMC"},{"url":"http://dx.doi.org/10.1002/jia2.26467","host_type":""}],"fields_of_study":["HIV/AIDS Research and Interventions","HIV, Drug Use, Sexual Risk","HIV/AIDS drug development and treatment","03 medical and health sciences","0305 other medical science","Adolescent","Adult","Female","Humans","Male","Middle Aged","Young Adult","Anti-HIV Agents","HIV Infections","Kenya","Pharmacies","Pilot Projects","Post-Exposure Prophylaxis","Pre-Exposure Prophylaxis"],"mesh_terms":["Adolescent","Adult","Female","Humans","Kenya","Male","Middle Aged","Pharmacies","Pilot Projects","HIV Infections","Anti-HIV Agents","Young Adult","Post-Exposure Prophylaxis","Pre-Exposure Prophylaxis"],"keywords":["Medicine","Pharmacy","Pre-exposure prophylaxis","Family medicine","Human immunodeficiency virus (HIV)","Condom","Service delivery framework","Men who have sex with men","Service (business)","Kenya","Hiv Prevention","Post‐exposure Prophylaxis","Pre‐exposure Prophylaxis","Private Pharmacies","Differentiated Service Delivery","Adult","Male","Pharmacies","Adolescent","Anti-HIV Agents","HIV Infections","Pilot Projects","RC581-607","Middle Aged","Young Adult","Humans","Female","Immunologic diseases. 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