{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:29:41Z","timestamp":1789086581028,"version":"build-2803163510"},"reference-count":42,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T00:00:00Z","timestamp":1755475200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000061","name":"Fogarty International Center","doi-asserted-by":"publisher","award":["D43 TW-011324"],"award-info":[{"award-number":["D43 TW-011324"]}],"id":[{"id":"10.13039\/100000061","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004423","name":"World Health Organization","doi-asserted-by":"publisher","award":["2023\/1363112-0"],"award-info":[{"award-number":["2023\/1363112-0"]}],"id":[{"id":"10.13039\/100004423","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>Expanding HIV pre-exposure prophylaxis (PrEP) through pharmacies may improve access for key populations. As part of the preparation phase of the EPIS (Exploration-Preparation-Implementation-Sustainment) framework, we developed and evaluated an online, self-paced PrEP training program for community pharmacists to prepare for a pilot, pharmacy-led PrEP service in Malaysia.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Materials and methods<\/jats:title>\n<jats:p>In May 2023, a PrEP training committee developed an online training program covering PrEP efficacy, safety, eligibility, baseline assessments, laboratory testing, prescribing, and special circumstances, and pre-\/post-training knowledge tests. In June 2023, 18 community pharmacists asynchronously completed the training. Effectiveness was evaluated using a 20-question pre-\/post-training knowledge test, with responses calculated into percentage scores, alongside participant feedback. Paired t-tests assessed knowledge score differences (p\u2009&lt;\u20090.05).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Participants (median age: 30.5 years [IQR: 5.8]; 78% female; 89% Chinese; median 6.5 years of experience [IQR: 4.5]; four with prior HIV-related experience) showed a mean increase in knowledge scores of 14.2% (95% CI: 8.2%\u201320.1%; p\u2009&lt;\u20090.001), increasing from 64.7% to 78.9%. Scores for four mid-career participants (50% female, 5\u201310 years of experience, all with undergraduate degrees, including one with prior HIV-related training), however, did not improve, suggesting that tailored learning approaches may be needed, and that existing knowledge or prior experience do not necessarily predict learning outcomes. PrEP knowledge gaps remained primarily in counseling (\u221222%), identifying candidates (\u221212%), clinical contraindications (\u22126%), effectiveness (\u22126%), and management of missed doses for daily PrEP (\u22126%), highlighting potential challenges in clinical decision-making and patient communication. Most pharmacists agreed that the training was well-structured, easy to understand, of appropriate duration, and useful for their work. Satisfaction was high, as was willingness to recommend it.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The novel online self-paced training program improved pharmacists\u2019 PrEP knowledge, though variability in knowledge gains suggests the need for enhancements. Incorporating case-based, problem-based, and simulation-based learning may improve comprehension, particularly in patient counseling, eligibility assessment, and PrEP contraindications.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0328713","type":"journal-article","created":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T17:23:06Z","timestamp":1755537786000},"page":"e0328713","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Development and evaluation of an online HIV pre-exposure prophylaxis (PrEP) training program for community pharmacists to implement pharmacy-led PrEP services in Malaysia"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5558-243X","authenticated-orcid":true,"given":"Yan Nee","family":"Gan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2884-5198","authenticated-orcid":true,"given":"Rafdzah","family":"Zaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Safia Alia","family":"Hafidzar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kwee Choy","family":"Koh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariani","family":"Ahmad Nizaruddin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosnida","family":"Mohd Noh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khairil Erwan","family":"Khalid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Yap","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederick L.","family":"Altice","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sin How","family":"Lim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iskandar","family":"Azwa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,8,18]]},"reference":[{"key":"pone.0328713.ref001","volume-title":"Integrated Biological and Behavioural Surveillance (IBBS) Survey 2022","author":"Ministry of Health Malaysia","year":"2024"},{"issue":"9","key":"pone.0328713.ref002","doi-asserted-by":"crossref","DOI":"10.1016\/S2352-3018(23)00150-9","article-title":"Global HIV control: is the glass half empty or half full?","volume":"10","author":"JB Nachega","year":"2023","journal-title":"Lancet HIV"},{"key":"pone.0328713.ref003","volume-title":"2024 Global AIDS Monitoring: Country Progress Report - Malaysia","author":"Ministry of Health Malaysia","year":"2024"},{"key":"pone.0328713.ref004","volume-title":"In danger: UNAIDS global AIDS update 2022","author":"Joint United Nations Programme on HIV\/AIDS (UNAIDS)","year":"2022"},{"key":"pone.0328713.ref005","volume-title":"National Strategic Plan: Ending AIDS 2016\u20132030","author":"Ministry of Health Malaysia","year":"2015"},{"key":"pone.0328713.ref006","volume-title":"Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations","author":"World Health Organization (WHO)","year":"2016"},{"key":"pone.0328713.ref007","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1016\/j.ijid.2020.09.546","article-title":"My PrEP Locator: PrEP directory in Malaysia","volume":"101","author":"ML Chong","year":"2020","journal-title":"Int J Infect Dis"},{"issue":"1","key":"pone.0328713.ref008","doi-asserted-by":"crossref","first-page":"14200","DOI":"10.1038\/s41598-023-41264-5","article-title":"Pre-exposure prophylaxis service among men who have sex with men in Malaysia: findings from a discrete choice experiment","volume":"13","author":"A Dubov","year":"2023","journal-title":"Sci Rep"},{"key":"pone.0328713.ref009","volume-title":"Size Estimation of Key Populations in Malaysia 2018","author":"Ministry of Health Malaysia","year":"2018"},{"key":"pone.0328713.ref010","volume-title":"Differentiated and simplified pre-exposure prophylaxis for HIV prevention: update to WHO implementation guidance. 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