Community pharmacy PrEP provision could be ‘transformative’ for HIV prevention

Enabling trained community pharmacies to provide PrEP would widen access, reduce health inequalities and ease pressure on overstretched sexual health clinics, according to a new report by leading HIV charity Terrence Higgins Trust.

Author of the ‘PrEP in Community Pharmacy: Policy options for widening PrEP access in England’ report, Deborah Gold, said: ‘We already know that PrEP works and that it is highly cost-effective. What this report shows is that the way PrEP is currently delivered is leaving too many people behind.

‘Community pharmacies are trusted, accessible and embedded in communities. With the right policy changes, they could play a transformative role in HIV prevention and help close the gaps in access that persist today.’

In England, most PrEP is accessed via sexual health services, but the report highlights that many people at risk of HIV cannot or will not attend clinics due to stigma, distance, inflexible opening hours, or competing responsibilities.

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In response, the report makes several recommendations to the NHS including enabling community pharmacies to access PrEP through existing national medicines procurement systems, developing a national Patient Group Direction (PGD), and agreeing a sustainable commissioning and payment model for pharmacies.

It also recommends that in advance of any expansion to actual dispensing, local authorities should ‘immediately explore’ commissioning community pharmacies to refer into existing pathways.

For example, allowing people who already access PrEP via a sexual health service to collect their continuation PrEP from a community pharmacy and have their follow-up appointments there.

A minimum training requirement would also be required for community pharmacy healthcare professionals so the Terrence Higgins Trust, the British Association for Sexual Health and HIV (BASHH) and the Centre for Pharmacy Postgraduate Education (CPPE) should collaborate to develop an appropriate online training package, the report suggests.

Henry Gregg, chief executive of the National Pharmacy Association (NPA), said: ‘This is an important report. Pharmacies already provide vaccinations to patients for flu and covid, making them more accessible and increasing uptake among groups who are less likely to get vaccinated.

‘Convenient and based on people's doorsteps, pharmacies make it quick and easy for people to protect themselves and their loved ones. With the right funding, it makes sense for the government to also use pharmacies for PrEP vaccinations, helping those who need it the most get protection they need from this life changing illness.’

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Recent UK Health Security Agency (UKHSA) data saw HIV diagnoses drop from 3,169 in 2023 to 3,043 across the UK in 2024, yet testing and treatment inequalities persist.

The highest uptake of PrEP was among white (79.4%) and ethnic minority (77.8%) men who have sex with men, while Black African heterosexual women (34.6%) and men (36.4%) had much lower uptake rates.

Geographic variations were also found, with diagnoses decreasing in London but increasing outside of London among heterosexual men.

In a roadmap published in February 2024, the government said it would continue exploring whether PrEP could be made available in primary care settings such as community pharmacies.

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However, ‘more evidence’ was needed ‘on the effectiveness’ of providing PrEP outside sexual health services.

In the HIV Action Plan for England for 2025 to 2030, published 1 December 2025, the government set out its ambition to improve PrEP uptake among underserved groups and ‘share best and/or promising practice of PrEP provision in other settings’.