Author ORCID Identifier

https:/orcid.org/ 0009-0009-9729-4968

Date Available

4-28-2025

Year of Publication

2025

Document Type

Graduate Capstone Project

Degree Name

Master of Public Health (M.P.H.)

College

Public Health

Department/School/Program

Public Health

Faculty

Richard Ingram

Committee Member

Chris Delcher

Faculty

Frank Romanelli

Faculty

Jayani Jayawardhana

Abstract

HIV transmission, with relative risk reductions of up to 99%. However, real world data have revealed that even with large increases in PrEP use, new HIV diagnoses may only slightly decline. This disparity suggests that access to PrEP may be suboptimal, especially among high-risk subgroups, who are often hard to maintain on the continuum of HIV care. Pharmacists, because of their accessibility, trusted role in their communities, and growing scope of practice, could serve as an intervention point to improve access to PrEP.

A previously validated algorithm using National Drug Codes (NDCs) and the International Classification of Disease, 10thedition (ICD-10) ensured the included prescriptions were attributable to HIV PrEP alone. Mean monthly PrEP prescriptions and the percent change over balanced pre-implementation and post-implementation periods was calculated according to each state’s month/year of authorization for pharmacist prescribing. Two-sample t-tests were used to compare the difference in means before and after implementation in each state where pharmacists can prescribe PrEP, which then was compared with a control over the same pre-defined time period in months.

In 80% of states where pharmacists can prescribe HIV PrEP (n=10), there was a greater relative increase in the mean rate of PrEP prescriptions per one hundred thousand persons after the establishment of prescriptive authority, compared to before. Pharmacists are highly accessible and trusted healthcare professionals with extensive education pertaining to the diagnosis, treatment, and management of chronic conditions including HIV. By expanding the pharmacist’s scope of practice to allow prescribing of HIV PrEP, significant strides could be achieved in terms of reducing barriers to HIV prevention and progress toward ending the HIV epidemic in the United States.

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