# Strengthening the HIV prevention continuum using pharmacies

> **NIH NIH R01** · EMORY UNIVERSITY · 2023 · $785,901

## Abstract

ABSTRACT
Early HIV diagnosis is an essential component of the strategy to End the HIV Epidemic (EHE). Yet, half of the
nearly 40,000 Americans who test positive for HIV every year have late (stage 3 AIDS) infection, which results
in higher community transmission and poorer treatment outcomes. In the United States South, where HIV is
disproportionately impacted, 50% of HIV infections are undiagnosed. Infrequent or delayed HIV testing is most
often due to poor healthcare access and stigmatizing attitudes about HIV that inhibit prevention and treatment
seeking. Thus, increased HIV testing access and uptake is urgently needed to normalize HIV testing and direct
individuals to pre-exposure prophylaxis (PrEP) if they test HIV negative or HIV treatment if they test HIV
positive. To increase HIV testing access and uptake, we propose integrating HIV prevention services
within community pharmacies located in neighborhoods with high HIV prevalence. Despite promising
evidence of feasibility of pharmacy-based HIV testing, it is not widely available. In fact, most local pharmacy
boards lack policy guidance on HIV testing being within their scope of practice. Our work has shown that HIV
testing uptake in community pharmacies can be increased if it is offered with less stigmatized non-HIV-related
services (e.g., COVID19, blood pressure, glucose, and cholesterol screening). But many community pharmacy
staff report inadequate training as barriers to integrating HIV testing into the pharmacy work system. Therefore,
to evaluate the implementation and effectiveness of HIV testing and prevention services within community
pharmacies we propose a hybrid type 1 study design that aims to 1) Examine the policy-, pharmacy staff- and
client-level barriers and facilitators of adopting HIV prevention services (e.g., HIV testing, PrEP referral, HIV
treatment referral) in community pharmacies, 2) Develop and implement pharmacy staff HIV prevention service
(e.g., HIV testing and counseling, PrEP referral, HIV treatment referral) trainings, and 3) Test the effects of
integrating HIV prevention services in community pharmacies with existing non-HIV-related screenings versus
those without on effectiveness and implementation outcomes. Guided by the Exploration, Preparation,
Implementation, Sustainment framework, this study will include an exploration phase that examines the
barriers and facilitators to pharmacy-based HIV prevention service provision across the US South using online
surveys of community pharmacy staff (n=300), and in-depth interviews of Board of pharmacy members (n=16)
and pharmacy staff (n=40). In the preparation phase, a virtual community pharmacy HIV prevention training
will be developed and offered to 150 community pharmacy staff. Finally, in the implementation and
sustainment phase, we will evaluate the acceptability and sustainment of the HIV prevention service delivery
over 12 months in 10 community pharmacies (5 pharmacies who offer primary prevention screenin...

## Key facts

- **NIH application ID:** 10619854
- **Project number:** 1R01MH132470-01
- **Recipient organization:** EMORY UNIVERSITY
- **Principal Investigator:** NATALIE D. CRAWFORD
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $785,901
- **Award type:** 1
- **Project period:** 2023-06-01 → 2028-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10619854

## Citation

> US National Institutes of Health, RePORTER application 10619854, Strengthening the HIV prevention continuum using pharmacies (1R01MH132470-01). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10619854. Licensed CC0.

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