Expanding HIV Prevention: Exploring Community Pharmacists' Willingness to Provide PrEP in Nigeria.

HIV remains a significant public health challenge in Nigeria. Pre-exposure prophylaxis (PrEP) effectively prevents HIV, but uptake is hindered by stigma, limited clinic access, and provider shortages. Community pharmacies could expand access, but their role in PrEP delivery remains underexplored. We assessed Nigerian community pharmacists' willingness and support needs for delivering pharmacy-delivered oral PrEP, examined association between sociodemographic factors and willingness, and compared pharmacy geolocations with sex worker hotspots and hospitals providing PrEP. A descriptive cross-sectional survey was conducted among licensed community pharmacists in Abuja and Lagos. Data collection was conducted using a hybrid approach (on-line and on-site) over two months from January to March 2025. Associations between sociodemographic factors and willingness to provide PrEP were examined using chi-square and Fisher's exact tests. ArcGIS distance analysis compared pharmacy geolocations with sex worker hotspots and hospitals offering PrEP. Of 267 pharmacists, 99.6% expressed willingness to deliver PrEP. Key support needs included PrEP guidelines training (92.1%), access to HIV rapid tests (81.3%), counseling skills (70.8%), and logistical support (70.8%). Structural readiness was high, with significant gender differences in willingness to serve gay, bisexual, and men who have sex with men (male: 85.6% vs. female: 67.3%; χ2 (1) = 0.22, p = 0.001). In Abuja and Lagos, 82.5% and 93.5% of key population hotspots, respectively, were closer to pharmacies than hospitals (p < 0.0001). Nigerian pharmacists are highly willing to provide PrEP. Training, particularly in gender-sensitive stigma reduction, and logistical support are essential for successful implementation.