Pharmacies could play key role in ending new HIV transmissions: new policy briefing

Community pharmacies should be at the heart of HIV prevention efforts by raising awareness of and providing access to PrEP (pre-exposure prophylaxis), according to a new policy briefing from the University of Bristol. PrEP is a pill that prevents HIV transmission.

Accessing PrEP through Pharmacies to Improve HIV Prevention is the first study of its kind in the UK. It was led by the National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) researchers Dr China Harrison and Professor Jeremy Horwood (co-director of the Sexual Health HIT).

It showed that pharmacies offer a more accessible, less stigmatising route to HIV prevention compared to sexual health clinics, which can be difficult for many people to access.

The study team reviewed international evidence, interviewed UK pharmacists and community members to design a pharmacy PrEP pilot. They piloted PrEP awareness raising and delivery in 5 pharmacies across the Bristol, North Somerset and South Gloucestershire region between October 2024 and April 2025.

They found low awareness of PrEP among pharmacists and community members, but strong support for pharmacy delivery as a convenient, trusted and less stigmatising option. Pharmacists expressed interest in delivering PrEP but highlighted the need for training, infrastructure, and changes to NHS policy to enable on-site prescribing and dispensing.

The researchers have produced a policy briefing, available via PolicyBristol: Pharmacy PrEP Delivery Briefing.

The briefing makes a series of recommendations, including:

• Embedding pharmacies in national HIV prevention strategies
• Scaling up UK pharmacy PrEP pilots to assess cost-effectiveness and equity
• Creating a national pharmacist PrEP training programme
• Supporting walk-in PrEP pharmacy consultations and integrating delivery into existing pharmacy public health services to reach under-served group
• Co-producing public awareness campaigns with under-served communities
• Amending NHS policy to allow pharmacies to stock and dispense PrEP directly, supported by integrated care models

Dr China Harrison said:

“PrEP is a powerful tool in preventing HIV, but current access routes don’t reach everyone who could benefit.

“Pharmacies are already part of people’s everyday lives. With the right support, they could transform access and support the Government’s goal of ending new HIV transmissions by 2030.”

Professor Jeremy Horwood said

“Our pilot demonstrates that pharmacy-based PrEP awareness and delivery is both feasible and acceptable. To realise its full potential, we need comprehensive training for pharmacy staff and targeted co-produced campaigns to raise awareness.

“Integrating PrEP into existing public health services within pharmacies offers a vital opportunity to reach underserved communities who may not access specialist sexual health services or lack knowledge of PrEP. The introduction of long-acting injectable PrEP presents an opportunity to further enhance pharmacy-based delivery while easing pressure on sexual health clinics.”

The work was funded by Gilead Sciences and supported by NIHR ARC West, alongside two NIHR Health Protection Research Units (HPRUs) – the HPRU in Evaluation and Behavioural Science at the University of Bristol and the HPRU in Blood Borne and Sexually Transmitted Infections at University College London.