High acceptability, feasibility and sustainability of a direct‐to‐pharmacy differentiated PrEP delivery model in public health HIV clinics in Kenya: perspectives of PrEP clients and healthcare providers

作者：Emmah Owidi, Kenneth Ngure, Vallery Ogello, Njeri Wairimu, Lydia Etyang, Winnie Waituika, Margaret Mwangi, Dominic Mwangi, Simon Maina, Elizabeth Irungu, Catherine Kiptinness, Nelly Mugo, Kenneth K. Mugwanya, for the Efficiency Study Team · 发表于：Journal of the International AIDS Society · 年份：2025 · DOI：10.1002/jia2.26442 · 被引用次数：6 · 研究领域：HIV/AIDS Research and Interventions、HIV, Drug Use, Sexual Risk、Pneumocystis jirovecii pneumonia detection and treatment

INTRODUCTION: High client opportunity costs and a burdened healthcare system limit oral pre-exposure prophylaxis (PrEP) delivery in Kenyan public HIV clinics. We conducted a qualitative study among PrEP clients and providers to understand the acceptability, feasibility and willingness to implement a client-centred, differentiated direct-to-pharmacy (DTP) PrEP refill visits intervention aimed at improving the efficiency of PrEP implementation in real-world clinics. METHODS: From March 2021 to March 2022, we conducted in-depth interviews with clients and healthcare providers participating in an individual facility pharmacy-based PrEP delivery model for PrEP refills among clients in the continuation phase at two public HIV clinics in central Kenya. The core components of the DTP model included directed-to-PrEP pharmacy refill visits conducted by facility pharmacy staff and client HIV self-testing (HIVST) while waiting for services at the pharmacy. We used semi-structured interview guides informed by the Consolidated Framework for Implementation Research (CFIR). We analysed data using thematic content analysis and organised findings by CFIR constructs. RESULTS: We interviewed 20 PrEP clients and 20 healthcare providers. PrEP clients included 15 females and had a median age of 39 years (interquartile range [IQR]: 33-48). Providers included 13 females, had a median age of 32 years (IQR: 30-41), and included 10 HIV counsellors, 5 pharmacy and 3 clinical providers. Both providers and...