Abstract

In the United States, 1.1 million persons are living with human immunodeficiency virus (HIV), and approximately 37,800 new infections occur annually. Ending the HIV epidemic requires reducing HIV transmissions by 90% within the next 10 years and requires expanded HIV testing, antivirals for persons infected with HIV, and scale-up of pre-exposure prophylaxis (PrEP) and postexposure prophylaxis (PEP) to prevent new infections. Community pharmacies are widely accessible and employ highly trained health care professionals on-site who can initiate PrEP and PEP. Recommendations are offered to implement a community pharmacy PrEP program. Pharmacy, government, and HIV prevention leaders must be prepared to support and promote transformative changes, including (1) modification or expansion of existing state-specific scope of practice to initiate PrEP and PEP, (2) encouraging pharmacist education about PrEP and PEP, (3) identification and screening of candidates for PrEP eligibility, (4) incorporating pharmacy laboratory ordering and monitoring logistics, (5) adjusting workflow and ensuring confidential spaces for sensitive discussions, and (6) addressing reimbursement to maintain pharmacist-delivered PrEP and PEP programs. HIV disproportionately affects minority communities and younger individuals who may not be engaged in the health care system. Community pharmacies are accessible and can help increase PrEP use. Expansion of community pharmacy PrEP programs are needed to help end the HIV epidemic. Implementation of PrEP requires adaptation of the pharmacy profession to support incorporation of PrEP in a community pharmacy. Endorsement and support of community pharmacists are needed to implement PrEP to increase HIV prevention efforts and expand pharmacists’ scope of practice.

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