AIDS patient care and STDs最新文献

{"title":"HIV Risk and Intention to Use HIV Pre-exposure Prophylaxis Among Sexually Active Female University Students in Zambia: A Cross-Sectional Survey to Understand Influential Factors.","authors":"Karen Hampanda, Matthew Bolt, Lillian Nayame, Madeleine Sehrt, Julia Thorne, Twaambo E Hamoonga, Margo S Harrison, Jillian Pintye, Alain Amstutz, Lisa L Abuogi, Oliver Mweemba","doi":"10.1177/10872914251382524","DOIUrl":"https://doi.org/10.1177/10872914251382524","url":null,"abstract":"<p><p>Limited research exists on HIV pre-exposure prophylaxis (PrEP) interest among female university students in high-HIV-prevalence African settings. This study sought to establish the relationship between epidemiological and perceived HIV risk and PrEP intention among young women in higher education in Zambia. We recruited female students at an urban university to complete an online survey on intention to use PrEP in the next year (primary outcome); PrEP knowledge, attitudes, and behaviors; demographics; epidemiological HIV risk; and risk perception. Descriptive statistics, regression, and mediation analyses were used. Of the 454 sexually active participants, 118 (26%) reported PrEP intention. Actual PrEP use was rare (<5%). The odds of PrEP intention increased for those with perceived high HIV risk [adjusted odds ratio (aOR) = 3.08; 95% confidence interval (CI): 1.71-5.55] and with each year at university (aOR = 1.47; 95% CI: 1.21-1.80) but decreased with higher PrEP stigma (aOR = 0.91; 95% CI: 0.86-0.96) and more negative PrEP perceptions (aOR = 0.91; 95% CI: 0.85-0.97). More epidemiological risk factors were originally associated with PrEP intention (aOR = 1.24; 95% CI: 1.01-1.53 for each risk factor), though this relationship weakened after adjustment for perceived HIV risk, which mediated 69% of the relationship between epidemiological HIV risk and PrEP intention. Only 23% of high-risk participants recognized their high epidemiological HIV risk (3+ risk factors). Along with PrEP education and stigma reduction, there is a need for approaches that help female university students in Zambia accurately identify their HIV risk to make informed decisions about PrEP use.</p>","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The AHORA Study: A Real-World Mixed-Methods Study Investigating the Effectiveness of, and Experiences with, Rapid Antiretroviral Therapy Initiation in People with Advanced HIV in the Rio Grande Valley, Texas.","authors":"Linda Mercado, Lionel Quiroga, Elias Cantu, Victoria Mena, Seth Francis-Graham, Cameron Costello, Eve Sullivan, Hannah Borda, Brenda Ng, Sha McCoy","doi":"10.1177/10872914251379972","DOIUrl":"https://doi.org/10.1177/10872914251379972","url":null,"abstract":"<p><p>The Rio Grande Valley (RGV) comprises counties with some of the highest prevalence of HIV in Texas. The predominantly Latino population also faces socioeconomic challenges, including high poverty rates, low health literacy, and transiency, contributing to increased risk of advanced HIV disease. AHORA was a real-world mixed-methods study evaluating viral control and immune reconstitution in a Latino population with advanced HIV disease, who were enrolled in a rapid start treatment program with bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) at two clinics in the RGV. To explore reasons for late diagnosis and experiences of rapid antiretroviral therapy (ART) initiation, document analysis and 27 in-depth semi-structured interviews were conducted with 18 individuals receiving treatment and 9 clinic staff. Median time to an HIV-1 RNA level <200 copies/mL was 5.3 weeks, with 90.5% (19/21) achieving this by Week 24. There were statistically significant differences in mean HIV-1 RNA levels, CD4% and CD4 counts between baseline and Week 24. Strategies to maximize ART engagement were grounded in person-centered care and included regular appointment reminders and transportation assistance. Common barriers to accessing care included limited HIV knowledge and financial constraints. These were addressed through education and financial support, including the provision of treatment samples at no cost, independent of insurance status. The AHORA study effectively showcases the benefits of rapid B/F/TAF initiation for individuals with advanced HIV in the RGV, facilitating early viral suppression and improved health outcomes. It also emphasizes the critical role of person-centered care and tailored support services in overcoming health care access barriers.</p>","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145197889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Forming Genuine Bonds: HIV Research Retention Strategies for Cisgender Women Vulnerable to HIV Acquisition.","authors":"Victoria W McDonald, Jessica Corcoran, Alexandria L Hahn, Corilyn Ott, Mirjam-Colette Kempf, Rebecca Schnall, Amy K Johnson","doi":"10.1177/10872914251379045","DOIUrl":"https://doi.org/10.1177/10872914251379045","url":null,"abstract":"<p><p>Cisgender women face significant HIV risks in the United States yet retention in prevention research is challenging. The same factors that increase HIV vulnerability also create barriers to research participation. This qualitative study explored multilevel barriers and facilitators to retaining cisgender women with increased HIV prevention needs in research using the social ecological model (SEM). Semi-structured interviews were conducted from August 2023 to February 2024 with 114 participants across three groups: HIV-negative cisgender women with increased HIV prevention needs (<i>n</i> = 34), cisgender women living with HIV (<i>n</i> = 40), and HIV prevention/treatment stakeholders (<i>n</i> = 40). Participants were recruited nationally through convenience sampling via social media and organizations. Directed content analysis was used to identify retention factors across individual, environmental, intervention, and structural levels. Barriers included substance use affecting contact maintenance, concerns about study time commitments, frustrations with unclear study procedures, poor staff rapport, safety concerns around intimate partner violence, historical research mistrust, and systemic vulnerabilities like housing instability. Facilitators included creating affirming environments that fostered purpose, flexible scheduling with incremental compensation, clear study expectations and health education/support, authentic staff relationships, discrete communication methods, transparent study procedures and approaches, virtual visit options, and availability of multiple contact methods. Findings corroborated a key paradox: those most vulnerable to HIV acquisition may be least likely to complete longitudinal studies due to structural barriers. Successful retention requires flexible approaches that address barriers at all SEM levels. These findings provide strategies for researchers to improve retention among cisgender women with increased HIV prevention needs, strengthening research representativeness and effectiveness.</p>","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145111708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HIV Services Implementation Within US Syringe Services Programs: A Qualitative Exploration.","authors":"Alexis M Roth, Elana Forman, Christopher F Akiba, William H Eger, Rose Laurano, Shelby L Huffaker, Sheila V Patel, Jessica Smith, Barrot H Lambdin, Angela R Bazzi","doi":"10.1177/10872914251376934","DOIUrl":"https://doi.org/10.1177/10872914251376934","url":null,"abstract":"<p><p>The recent rise in HIV incidence among people who inject drugs in the United States highlights an urgent need to improve HIV testing, treatment linkage, and pre-exposure prophylaxis access in this group. Syringe services programs (SSPs) play a critical role by offering or linking clients to these services, yet little is known about how such care is delivered. Informed by the Consolidated Framework for Implementation Research, we conducted qualitative interviews with 41 representatives from 27 SSPs across the United States to characterize the current service delivery landscape, identify barriers to care, and explore modifiable implementation determinants. Rapid qualitative analysis revealed four primary HIV service delivery models: \"one-stop shop\" offering integrated, on-site HIV testing and follow-up care provided by the SSP; \"test and refer\" with integrated, on-site testing services followed by referrals to external partners for follow-up care; \"co-located services\" with SSPs relying on external partner organizations to provide HIV testing (and additional services) on-site; and \"hand-off\" involving referrals to off-site, external partners for HIV testing and follow-up care. SSPs faced varied implementation challenges, including staffing, funding, and space constraints; competing priorities; availability and accessibility of local partnerships; as well as SSP culture, which values participant autonomy (recipient-centeredness). These contextual factors influenced the feasibility and acceptability of HIV services and why SSPs adopted a particular service delivery model. To strengthen HIV prevention and care in SSPs, tailored implementation strategies are needed that account for programs' unique constraints and capacities.</p>","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantifying Structural Disadvantage in HIV Prevention: Development and Validation of the HIV-Specific Social and Structural Determinants Index in the United States.","authors":"Chen Zhang, Yao Tang, Wonkyung Kniffen, Yu Liu","doi":"10.1177/10872914251374573","DOIUrl":"https://doi.org/10.1177/10872914251374573","url":null,"abstract":"<p><p>Structural inequities significantly shape disparities across the HIV care continuum, yet few validated tools exist to quantify HIV-specific structural vulnerability at the population level in the United States. This study introduces and validates the HIV-Specific Social and Structural Determinants of Health Index (HIV-SSDI), a multi-dimensional, state-level index designed to capture structural disadvantage relevant to HIV prevention and care. Using publicly available state-level index (2008-2023) spanning nine structural domains, we developed the HIV-SSDI through exploratory factor analysis with three extraction methods: principal component analysis, maximum likelihood, and minimum residual. We constructed HIV-SSDI scores based on normalized factor loadings and evaluated their associations with HIV care continuum outcomes, using cross-sectional and longitudinal linear regression models. Three consistent latent factors emerged across methods: (1) socioeconomic and health care disadvantage, (2) HIV service infrastructure and urban density, and (3) structural/legal context. Higher HIV-SSDI scores were significantly associated with HIV prevalence, mortality, preexposure prophylaxis (PrEP) use, and testing rates but not with linkage to care or viral suppression. Longitudinally, the strength of association between SSDI and diagnosis rates declined between 2008 and 2022, while SSDI associations with PrEP use and PrEP-to-Need-Ratio increased sharply from 2012 to 2023. These trends were robust across factor extraction methods and model specifications. The HIV-SSDI is a validated, multi-dimensional metric that captures structural disadvantage relevant to HIV vulnerability and prevention. Its growing association with prevention outcomes over time supports its utility as a policy-relevant tool for identifying high-need states, guiding equitable resource allocation, and monitoring progress toward HIV-related health equity.</p>","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144999475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Letter:</i> Navigating HIV PCR Results in the Era of Long-Acting Injectable Pre-Exposure Prophylaxis.","authors":"Hilal Abdessamad, Shawnalyn W Sunagawa, Anthony T Podany, Catherine M Creticos, Joshua Forgy, Theppharit Panichsillapakit, Dima Dandachi","doi":"10.1089/apc.2025.0060","DOIUrl":"10.1089/apc.2025.0060","url":null,"abstract":"","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":"339-341"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143951853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adapting an Intervention to Improve Adolescent Sexual Health Assessment and Pre-Exposure Prophylaxis Prescription by Family Medicine Physicians in Alabama.","authors":"Madeline C Pratt, Oluwaseyi O Isehunwa, Samantha V Hill, Tina Simpson, Robin Gaines Lanzi, Nicholas Van Wagoner, Brook A Hubner, Douglas Krakower, Tara E Wood, Latesha E Elopre, Lynn T Matthews","doi":"10.1089/apc.2025.0064","DOIUrl":"10.1089/apc.2025.0064","url":null,"abstract":"<p><p>High HIV incidence in the US South disproportionately affects adolescents, young adults, and Black women. Using a community-engaged approach and intervention mapping, we developed PrEP-Pro, an intervention to support family medicine physician-trainees to elicit a sexual history from and provide pre-exposure prophylaxis (PrEP) to adolescents, with special emphasis on engaging with Black adolescent girls and young women (AGYW). Intervention content includes PrEP curricula, adaptations to the Centers for Disease Control and Prevention (CDC)'s sexual history tool, and a PrEP Champion training program. Two community advisory boards (CABs)-one consisting of PrEP Champions and physicians, the other of AGYW-and two focus group discussions with physicians (<i>N</i> = 7) informed intervention content. We pretested PrEP-Pro at two sites over 3 months and assessed acceptability, appropriateness, feasibility. The provider CAB advised multiple training strategies: (1) locally informed sexual history videos; (2) HIV epidemiology review; (3) quick-reference badge and pocket cards on PrEP and eliciting sexual histories; (4) didactic, case-based content; (5) web-based content. The AGYW CAB informed development of (6) a sexual history screener and (7) clinic posters emphasizing confidentiality for adolescent clients. Across two family medicine residency programs, eight physicians participated in the 3-month pretest of the intervention. Acceptability (mean = 4.16/5 [standard deviation (SD) = 1.36]), appropriateness (4.16/5 [1.36]), and feasibility (4.19/5 [1.37]) were high. Six physician interviews informed adaptations including fostering a community of practice, increased case-based learning, and quick-reference card content modifications. We combined theory-driven and evidence-informed components to adapt and pilot PrEP-Pro to support physicians in discussing PrEP with adolescents. The adapted intervention was piloted across clinics to inform a future trial.</p>","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":"371-379"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12411089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144582812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors for Major Adverse Cardiovascular Events in Antiretroviral Therapy-Treated People with HIV: A Long-Term Cohort Study in Turkey.","authors":"Ceren Atasoy Tahtasakal, Dilek Yıldız Sevgi, Sibel Yıldız Kaya, Zühal Yeşilbağ, İnci Yılmaz Nakir, Alper Gündüz, Okan Derin, Bilgül Mete, Ahsen Öncül, Hayat Kumbasar Karaosmanoğlu, Esra Zerdali, Fehmi Tabak","doi":"10.1177/10872914251359817","DOIUrl":"10.1177/10872914251359817","url":null,"abstract":"<p><p>People living with HIV (PLWH) continue to experience longer life expectancy due to effective antiretroviral therapy (ART). However, cardiovascular disease (CVD) has become a leading cause of morbidity and mortality. Despite improved HIV care, major adverse cardiovascular events (MACE) remain prevalent, with limited data from long-term cohorts. This study aimed to determine the incidence, risk factors, and predictors of MACE in long-term ACTHIV-IST cohort of PLWH in Istanbul. We conducted a retrospective analysis of 1059 patients followed for at least 10 years. Patients with prior MACE or noncardiac mortality were excluded. Traditional CVD risk factors, HIV-related immunovirological parameters, ART, and comorbidities were analyzed using Cox proportional hazards regression. MACE incidence was 7.55% (80/1059) with a cumulative rate of 11.1%. The most frequent events were ischemic heart disease (30.4%), myocardial infarction (27.6%), and sudden cardiac death (18.6%). Among those without traditional CVD risk factors, a CD4⁺ count <200 cells/mm³ at diagnosis was associated with a 4.5-fold increased MACE risk. Hypertension (hazard ratio [HR]: 4.74), coronary artery disease (CAD) (HR: 8.49), and older age at HIV diagnosis (HR: 1.031/year) were the strongest independent predictors (<i>p</i> < 0.05). Patients who should have used statins but did not were at higher risk of developing MACE (34% vs. 17%) compared to those who did (<i>p</i> < 0.05). Twenty-one statin users of those who had MACE were before the event. A significantly higher MACE rate was observed in patients who used protease inhibitor (PI) compared to those who did not (<i>p</i> = 0.002). Low baseline CD4⁺ T-cell count, prolonged HIV duration, comorbidities (e.g., hypertension, CAD, and dyslipidemia), PI experienced, and older age at HIV diagnosis significantly increase MACE risk. Early diagnosis, continuous cardiovascular monitoring, start statins if indicated, and individualized ART strategies are essential to reduce MACE-related morbidity and mortality in PLWH.</p>","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":"342-352"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144666824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"We're Going to Be Here\": Providers' Perspectives on Implementing a Revised HIV Care Coordination Program.","authors":"Connor Emmert, Tigran Avoundjian, Mary Irvine, Thamara Tapia-Munoz, Rachel Schenkel, Miguel Hernandez, Sarah Kozlowski, Denis Nash, Honoria Guarino","doi":"10.1089/apc.2025.0047","DOIUrl":"10.1089/apc.2025.0047","url":null,"abstract":"<p><p>As HIV outcomes continue to improve, disparities in viral suppression and care engagement persist, exacerbated by socioeconomic inequities, mental health stressors, systemic racism, HIV-related stigma, and other forms of discrimination. HIV care coordination programs address structural and psychosocial barriers to care and treatment, but these interventions must adapt to the evolving circumstances and perspectives of those expected to participate in them to achieve and sustain maximal impact. In 2009, the New York City Department of Health implemented a Ryan White-funded HIV Care Coordination Program (CCP). The CCP has demonstrated effectiveness, particularly among those newly diagnosed with HIV and those out of care or unsuppressed in the prior year. However, implementation challenges prompted a 2018 redesign to increase provider and client engagement. We conducted 30 semi-structured interviews with providers from six agencies delivering the revised CCP to examine barriers and facilitators to implementation. Providers highlighted the revised CCP's flexible, client-centered approach as a strength, allowing for personalized care plans and improved client engagement. Additionally, they emphasized the contributions of driven, committed staff. However, providers noted several barriers associated with the revised model or its implementation context, including increased paperwork burden, unrealistic service expectations, understaffing, and burnout from uncompensated emotional labor. Our findings suggest the value of retaining a client-centered model while streamlining administrative processes, enhancing training and support for providers, and increasing staff-client ratios. Adjustments based on providers' experience with a complex intervention can improve the fit of the intervention to its intended delivery settings and promote sustainability.</p>","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":"363-370"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12411091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144273948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation Determinants of HIV Testing and Pre-Exposure Prophylaxis in Community Pharmacies in Philadelphia, PA.","authors":"Cedric H Bien-Gund, Anna Sweeney, Brandon Ptak, Michelle Jeon, David Koren, Javontae Williams, Kathleen A Brady, Jose Bauermeister, Sarah M Wood","doi":"10.1177/10872914251365540","DOIUrl":"10.1177/10872914251365540","url":null,"abstract":"<p><p>Delivering HIV testing and pre-exposure prophylaxis (PrEP) in community pharmacies can expand access to HIV services for populations with limited access to care. However, few pharmacies in the United States have successfully implemented these services. We investigated implementation barriers and facilitators of pharmacy-based HIV testing and PrEP initiation in Philadelphia, an Ending the HIV Epidemic priority jurisdiction with high rates of HIV and bacterial STIs, located in a state with relatively restrictive laws governing pharmacy scope of practice. Using a sequential, exploratory mixed-methods study design, we conducted 15 in-depth interviews with pharmacists and key implementing partners, followed by an online survey of pharmacists, pharmacy students, and technicians (<i>n</i> = 59). Interviews and surveys were analyzed using the Consolidated Framework for Implementation Research. Data were collected from October 31, 2023, to October 17, 2024. Interviewees representing three pharmacy sites had initiated HIV testing, but no sites had yet successfully implemented pharmacy-based PrEP. The primary barriers to delivering HIV testing were based on inner setting barriers (existing work burden, overly complex protocols). Legal restrictions and reimbursement concerns were the primary barriers to implementing pharmacy-based PrEP. Participants described potential solutions and mitigating strategies to these barriers, such as collaborative practice agreements and developing standing orders with medical providers, integration with telePrEP models, streamlined blueprints and protocols, and practice-based champions. Survey respondents indicated high levels of acceptability but lower levels of perceived implementation feasibility. To optimize implementation sustainability and success, implementation strategies need to adequately address legal barriers and reimbursement concerns and be integrated into the pharmacy workflow.</p>","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":"353-362"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144803198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}