(1204) College Students’ Acceptability and Perceived Appropriateness of Pharmacist-led Prescribing of HIV Pre-exposure Prophylaxis in a Community Setting

Objectives: Nationwide, only 25% of individuals eligible for human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) received PrEP medications as of 2021. The campus of a large, public university in Indiana is regarded as highly LGBTQ friendly, with an estimated 8,000-10,000 students who identify with diverse genders and sexualities. However, only approximately 55 individuals fill PrEP with the University pharmacy. Although providers within the nearby student health center are able to prescribe PrEP, appointments tend to be booked approximately a week or more out, potentially limiting access to care on campus for students. Currently, no pharmacy-based PrEP service exists on campus and implementation of one has the potential to improve access. The objectives of this study include characterizing college students’ acceptability and perceived appropriateness for, as well as identifying barriers and solutions to, a community pharmacist-led PrEP-prescribing service.

Methods: This is a sequential, explanatory mixed-methods study. A cross-sectional survey will be followed by semi-structured interviews. Any individual who is a student at the University, is at least 18 years or older, and meets at least one indication for a PrEP prescription is considered eligible for participation in our survey. Individuals will be recruited for participation in the survey primarily via email lists, social media, and messaging groups affiliated with the LGBTQ Center. Immediately following the completion of the survey, participants will be asked if they would like to be considered for a brief, audio-recorded semi-structured interview to collect further information on responses and perceptions. Participation in both the survey and interviews will be voluntary and compensated for.
Survey development will be informed by the Outcomes for Implementation Research framework devised by Proctor et al. to evaluate patient acceptability and perceived appropriateness of community pharmacists prescribing HIV PrEP medications. The multiple-item survey will collect information in the following categories: 1. eligibility for participation, 2. information about acceptability and perceived appropriateness of pharmacist-led prescribing, including that of PrEP, and 3. participant demographics. A 5-point Likert scale (1=strongly agree, 5=strongly disagree) will be utilized as appropriate. Descriptive statistics will be used to analyze the survey data. The semi-structured interview guide will also be developed based on Proctor’s framework. The addition of interviews with select participants will allow for elaboration on both positive and negative perceptions of appropriateness and acceptability of a pharmacist-led PrEP service on campus through open-ended responses. Interview transcripts will be coded via a hybrid deductive and inductive approach. Survey and interview data will be synthesized to characterize acceptability, appropriateness, barriers, and solutions. This protocol will be submitted and approved by the Purdue University Institutional Review Board prior to commencing study procedures.

Results: Preliminary data will be presented at the APhA Annual Meeting in March 2024.

Conclusions: The results of this study will provide insight into college-aged students’ views on the acceptability and appropriateness of community pharmacists prescribing PrEP. Additionally, this study will explore potential barriers to uptake of a community-based, pharmacist-led PrEP service on a college campus. The results of this study can be utilized to assist in furthering pharmacists’ scope of practice and to aid in the development of a service in the future, allowing increased access to preventative care for an underserved community.