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Evaluation of a Collaborative Practice Agreement Intervention to Improve Access to HIV Prevention Services in
Chante Hamilton1, Alexis Hudson1, Christina Chandra2
1Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, 1518 Clifton Road, NE, Atlanta, GA, 30322, United States, 1 4047129445.
Background:
The United States (US) Southeast experiences a disproportionate burden of HIV, compounded by limited access to pre-exposure prophylaxis (PrEP) services due to systemic barriers, such as stigma, medical mistrust, and restrictive pharmacy policies. Collaborative practice agreements (CPAs) between pharmacists and clinicians represent a promising strategy to improve PrEP accessibility through pharmacy-based services.
Objective:
The Collaborative Agreement-based PrEP Using Pharmacies (CAP-UP) study aims to evaluate the development, implementation, and effectiveness of a CPA template and training resources to enhance pharmacy-based PrEP initiation and adherence in the Southeastern US.
Methods:
The CAP-UP study uses a hybrid type 1 effectiveness-implementation design guided by integrated implementation science frameworks. It includes three phases: (1) exploration, using online surveys and in-depth interviews to identify barriers and facilitators to CPA implementation; (2) preparation, developing and refining a CPA template and training resources; and (3) implementation, piloting the CPA template in 10 community pharmacies within high-HIV-prevalence neighborhoods.
Results:
The CAP-UP study was funded in October 2023 by the National Institutes of Health through the Center for AIDS Research (grant P30-AI050409-25S1) as an Ending the HIV Epidemic supplement. Recruitment launched in November 2023 and is actively ongoing, with 264 pharmacy staff having completed surveys as of January 2026. The study aims to recruit a total of 300 participants for surveys and conduct 68 in-depth interviews by February 2026.
Conclusions:
Expanding HIV prevention services through community pharmacies represents a practical and impactful strategy for addressing inequities in HIV prevention that advances health equity. By leveraging implementation science frameworks, our study explores a novel approach to integrating HIV prevention services in pharmacies located in areas with high HIV prevalence. Findings from this work will contribute to the evidence base needed to optimize pharmacy-based PrEP delivery and support the national goal of Ending the HIV Epidemic in the US.
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