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A scheme to test the feasibility of delivering HIV pre-exposure prophylaxis (PrEP) via community pharmacies is currently underway in five pharmacies across Bristol, South Gloucestershire and North Somerset, the University of Bristol has told The Pharmaceutical Journal.
The pilot is being run by the university as part of research commissioned by the National Institute for Health and Care Research. It began in October 2024 and will end in spring 2025, with a paper expected to be published later this year.
A previous study, conducted by the university and published in March 2024, identified several barriers that community pharmacies would need to overcome to provide the service, including a lack of awareness and knowledge about PrEP, training among pharmacists and privacy and facilities within pharmacies.
The study also identified facilitators of pharmacy-based PrEP delivery, which included raising awareness of PrEP, providing PrEP-specific training for pharmacists and pharmacy accessibility, including proximity within the community, extended opening hours and walk-in services.
The authors suggested developing a training intervention, focusing on raising awareness and educating both pharmacists and community members about PrEP delivery. They also said that systemic changes, such as funding and infrastructure improvements, would be necessary to support PrEP delivery via pharmacies, as well as policy changes allowing pharmacies to access NHS PrEP stock.
A report on pharmacy, published by the Health and Social Care Committee in May 2024, recommended that NHS England commissions community pharmacies to provide PrEP.
In its response to the recommendations, published on 10 January 2025, the government said the recommendation would be “reviewed alongside the existing clinical guidelines and emerging evidence from the pilot study” at the University of Bristol.
Elen Jones, director for Wales at the Royal Pharmaceutical Society, said: “We welcome the long-awaited pilots of PrEP through community pharmacies. This initiative highlights the vital role community pharmacies play in improving access to preventive care.
“These pilots are a positive step in addressing health inequalities and improving public health. As the government looks to develop a ‘neighbourhood health service’, we would urge ministers to act on the Health and Social Care Committee’s recommendation to widen access to PrEP via community pharmacy and ensure that this is delivered through the forthcoming HIV action plan.”
Richard Angell, chief executive of HIV and sexual health charity the Terrence Higgins Trust, said: “PrEP access in pharmacies could be the silver bullet we need. PrEP has been a game-changer in the fight to stop new HIV transmissions, but at the moment it’s not reaching everyone who can benefit. There are serious inequalities by race, gender and age in who is offered PrEP and who is accessing it.
“There are long waiting lists to access PrEP through sexual health services, with more than half of people seeking appointments waiting more than 12 weeks to be seen,” he added.
Referring to a target in the government’s HIV action plan, Angell said: “We are not on track to reach our national target to end new HIV transmissions by 2030. To make this goal a reality, the government must ensure that everyone who can benefit from PrEP can access it, including online and through pharmacies.”
PrEP has been routinely available from specialist sexual health services in the UK since 2020. However, plans to increase access in England have been in discussion since the publication of ‘Towards zero: the HIV action plan for England — 2022 to 2025‘.
The ‘PrEP access and equity task and finish group’, established by the Department of Health and Social Care (DHSC) in October 2022 to identify ways of improving access to PrEP, as part of the HIV action plan, recommended the establishment of a series of national pilots for PrEP provision in settings outside specialist sexual health clinics, including pharmacies.
The ‘Roadmap for meeting the PrEP needs of those at significant risk of HIV‘, commissioned by the DHSC and produced by the independent HIV Action Plan Implementation Steering Group, was published in February 2024, after originally being promised for the end of 2023. It revealed that recommendations for pilots to explore how PrEP could be available via community pharmacies were being considered as “possible future opportunities”.
A spokesperson for the DHSC told The Pharmaceutical Journal on 16 January 2025: “This government is committed to tackling HIV, and we have commissioned a new action plan with the goal of achieving no new HIV transmissions in England by 2030.
“As part of that work, we are looking at options to improve access to PrEP outside sexual health services, including online and through pharmacies.”
In December 2024, The Pharmaceutical Journal reported that PrEP could be provided in community pharmacies in Wales from autumn 2025.
