{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T17:28:06Z","timestamp":1793294886906,"version":"4.5.0"},"reference-count":28,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T00:00:00Z","timestamp":1756166400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["AIDS Patient Care and STDs"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:p>\n                    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 (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 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.\n                  <\/jats:p>","DOI":"10.1177\/10872914251365540","type":"journal-article","created":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T19:54:40Z","timestamp":1758916480000},"page":"353-362","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Implementation Determinants of HIV Testing and Pre-Exposure Prophylaxis in Community Pharmacies in Philadelphia, PA"],"prefix":"10.1177","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0182-5680","authenticated-orcid":false,"given":"Cedric H.","family":"Bien-Gund","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA."},{"name":"Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA."},{"name":"Center for Clinical Epidemiology and Biostatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Sweeney","sequence":"additional","affiliation":[{"name":"School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9576-4972","authenticated-orcid":false,"given":"Brandon","family":"Ptak","sequence":"additional","affiliation":[{"name":"Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Jeon","sequence":"additional","affiliation":[{"name":"School of Health Professions, Philadelphia College of Pharmacy, Saint Joseph\u2019s University, Philadelphia, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6601-9893","authenticated-orcid":false,"given":"David","family":"Koren","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, School of Pharmacy, Temple University, Philadelphia, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javontae","family":"Williams","sequence":"additional","affiliation":[{"name":"Division of HIV Health, Philadelphia Department of Public Health, Philadelphia, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen A.","family":"Brady","sequence":"additional","affiliation":[{"name":"Division of HIV Health, Philadelphia Department of Public Health, Philadelphia, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose","family":"Bauermeister","sequence":"additional","affiliation":[{"name":"Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA."},{"name":"School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah M.","family":"Wood","sequence":"additional","affiliation":[{"name":"Division of Adolescent Medicine, Icahn School of Medicine, Mount Sinai, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,8,26]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.2147\/ppa.S30244"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2010.0324"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/1715163517745517"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0134631"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2022.839479"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2018.0294"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1071\/SH18084"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofz365"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.japh.2019.06.021"},{"key":"e_1_3_5_11_2","unstructured":"National Alliance of State & Territorial AIDS Directors. Issue Brief: Pharmacist Authority to Initiate PrEP & PEP and Participate in Collaborative Practice Agreements. August 10 2023. Available from: https:\/\/nastad.org\/sites\/default\/files\/2023-08\/PDF-Pharmacist-Authority-Initiate-PrEP-PEP.pdf [Last accessed: November30 2024]."},{"key":"e_1_3_5_12_2","unstructured":"Research I These US. Cities Have the Highest STI Rates. January 13 2025. Available from: https:\/\/www.innerbody.com\/std-testing\/std-statistics [Last accessed: March15 2025]."},{"key":"e_1_3_5_13_2","unstructured":"Philadelphia Department of Public Health Division of HIV Health. Surveillance Report 2022. December 28 2023. Available from: https:\/\/www.phila.gov\/media\/20231228103020\/HIVSurveillance_Report_2022.pdf [Last accessed: November20 2024]."},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-4-50"},{"key":"e_1_3_5_15_2","volume-title":"Designing and Conducting Mixed Methods Research","author":"Creswell JW","year":"2017","unstructured":"Creswell JW, , Plano Clark VL. Designing and Conducting Mixed Methods Research. 3 ed. 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PA Medicaid to Allow Pharmacists to Enroll as Providers and Bill for Pharmacy Services. February 12 2024. Available from: https:\/\/www.papharmacists.com\/news\/664824\/PA-Medicaid-to-Allow-Pharmacists-to-Enroll-as-Providers-and-Bill-for-Pharmacy-Services.htm [Last accessed: November30 2024]."}],"container-title":["AIDS Patient Care and STDs"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10872914251365540","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10872914251365540","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10872914251365540","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T18:09:03Z","timestamp":1777399743000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/full\/10.1177\/10872914251365540"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,26]]},"references-count":28,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1177\/10872914251365540"],"URL":"https:\/\/doi.org\/10.1177\/10872914251365540","relation":{},"ISSN":["1087-2914","1557-7449"],"issn-type":[{"value":"1087-2914","type":"print"},{"value":"1557-7449","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,26]]}}}