Pharmacy-centered Rapid ARV Network: Capacity-building for status-neutral ART/PrEP services within Southern community pharmacies

Modified Project Summary/Abstract Section HIV disproportionately affects the Southern United States with the highest burden of new infections. While biomedical HIV prevention strategies, such as pre-exposure prophylaxis (PrEP) and treatment as prevention can effectively prevent HIV acquisition and transmission, innovative strategies are still needed to ensure these tools are employed in the communities most impacted by the epidemic. Alabama, one of seven priority states in the U.S. Department of Health and Human Services Ending the HIV Epidemic initiative, recently permitted collaborative practice agreements between physicians and pharmacists. Over half of all pharmacies operating in Alabama are community-based with many operating in areas of the state of higher HIV incidence. Rapid status neutral approaches can improve linkage to HIV service delivery, and pharmacy-based HIV testing in pharmacies has been effective in other regions. However, critical gaps remain in understanding how to effectively incorporate HIV testing and service delivery in pharmacy settings in Alabama and other regions of the Southern US. To close that gap, this proposed study will pursue two specific aims: (1) Evaluate key determinants for implementation of a test-to-treat, status neutral rapid antiretroviral (ARV) intervention into independent pharmacy settings through concurrent mixed-methods; (2) Develop and refine a multi-component implementation strategy to integrate HIV testing, PrEP, and ART in routine pharmacy-based practice. Upon completion of our proposed research, our inter-disciplinary team, which includes experts in infectious diseases and HIV PrEP/ARV service delivery, implementation science, community-engaged research, and pharmacy care delivery, will lead to a multi-site type III implementation trial of PrEP service delivery at community pharmacies across the South.