Evaluation of an HIV pre-exposure prophylaxis navigation and pharmacist-delivered clinical services model implemented at a municipal sexually transmitted infections clinic, 2017-2023.

BACKGROUND

Primary care providers have increasingly become trained in human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) prescribing; however, major barriers persist among patients in being able to comfortably and confidentially engage in PrEP conversations with their primary care provider.

OBJECTIVE

Herein, we describe and evaluate an alternative, pharmacist-delivered PrEP care model at a municipal sexually transmitted infection (STI) clinic, implemented in conjunction with PrEP navigators, to serve as a safety-net access point among priority populations. While there has been recent advocacy for increased implementation of pharmacist-delivered PrEP care models, this model of PrEP care has not been widely studied.

PRACTICE DESCRIPTION: The County of Santa Clara's STI Clinic is a safety net clinic that provides sexual health evaluation and treatment services, as well as PrEP, to its patient population.

PRACTICE INNOVATION: Under a pharmacist-delivered PrEP care model, pharmacists furnish PrEP patients without a physician prescription, and receive support from navigators to enroll patients into payment assistance programs, schedule initial and quarterly follow-up appointments, and provide translation services.

EVALUATION

METHODS

This evaluation presents the characteristics of patients referred for PrEP navigation as well as those that were either linked or scheduled directly for PrEP initiation and follow-up appointments since the inception of this pharmacist-delivered PrEP care model in 2017.

RESULTS

Between 2017 and 2023, a total of 545 patients initiated PrEP with 379 (69%) initiating PrEP following receipt of navigation services. A total of 61% identified as Hispanic or Latino, 97% as male, and 72% were between the 25-44 age range at the time of initiation. The clinic experienced an approximate 3-fold increase in patient encounters with 216 initiating PrEP within the first 12-months of pharmacist-delivered PrEP care model implementation to 608 in 2023.

CONCLUSION

Pharmacists have an opportunity to contribute to efforts aiming to end the HIV epidemic by becoming trained and furnishing PrEP to priority populations in local municipalities.