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Establishing a Pharmacy-Based Pre-Exposure Prophylaxis Program for Young Women Who Sell Sex: Protocol for a
Oppah Kuguyo1, Helena Archer2, Lance Azizi2
1Department of Sexual and Reproductive Health, Centre for Sexual Health HIV/AIDS Research Zimbabwe, Harare, Zimbabwe.
JMIR Research Protocols
|December 3, 2025
Summary
This study piloted the Together Optimizing PrEP Access in Zimbabwe (TOPAZ) intervention, offering HIV pre-exposure prophylaxis (PrEP) refills through pharmacies for sex workers. The pharmacy-based model aims to improve PrEP continuation and reduce HIV risk in this key population.
Area of Science:
- Public Health
- HIV Prevention
- Implementation Science
Background:
- Sex workers (SWs) face elevated HIV risks and low uptake of preventive measures like pre-exposure prophylaxis (PrEP).
- Community-based programs enhancing PrEP accessibility and convenience can significantly improve adherence and reduce HIV transmission.
Purpose of the Study:
- To co-develop and pilot the Together Optimizing PrEP Access in Zimbabwe (TOPAZ) intervention, enabling SWs to access PrEP refills at pharmacies.
- To evaluate the feasibility, acceptability, and effectiveness of pharmacy-based PrEP refills for improving PrEP continuation among SWs.
Main Methods:
- A participatory approach involving SWs and pharmacy owners to design the TOPAZ intervention, including convenient refill pickups and incentives.
- A cluster-randomized pilot trial comparing pharmacy-based PrEP refills to standard clinic-based pickups, assessing PrEP retention at multiple time points.
- Mixed methods research to assess implementation outcomes (acceptability, feasibility, etc.) and inform future scaling and effectiveness trials.
Main Results:
- Participant enrollment began in March 2024, with data collection concluding in May 2025.
- Comprehensive data analysis is scheduled for February 2026.
- The study will provide preliminary data on PrEP retention and implementation outcomes.
Conclusions:
- The TOPAZ intervention demonstrates a promising strategy for improving PrEP continuation among SWs through accessible pharmacy-based refills.
- Successful piloting could lead to a larger effectiveness trial, potentially transforming HIV prevention delivery for key populations.
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