International Journal of Clinical Pharmacy

, Volume 34, Issue 6, pp 803–806 | Cite as

Pharmacists as providers of HIV pre-exposure prophylaxis

  • Christine Bruno
  • Parya SaberiEmail author


The efficacy of HIV pre-exposure prophylaxis (PrEP) has been demonstrated in four clinical trials to date; however, the success of PrEP is largely dependent on high levels of medication adherence. Due to their extensive experience and expertise in medication adherence counseling, as well as their ability to monitor and manage medication adverse effects and drug–drug interactions, clinical pharmacists are well-equipped to play a key role in effective PrEP utilization. Here we discuss reasons favoring the establishment of a protocol-based, pharmacist-run PrEP clinic.


Adherence HIV/AIDS Pharmacist Pre-exposure prophylaxis Prevention PrEP 



The project described was supported by NIH award numbers F32MH086323 and K23MH097649.



Conflicts of interest



  1. 1.
    UNAIDS. UNAIDS fact sheet. Geneva, Switzerland: Joint United Nations Programme on HIV/AIDS; 2011; Available from:
  2. 2.
    Abdool Karim Q, Abdool Karim SS, Frohlich JA, Grobler AC, Baxter C, Mansoor LE, et al. Effectiveness and safety of tenofovir gel, an antiretroviral microbicide, for the prevention of HIV infection in women. Science. 2010;329(5996):1168-74.Google Scholar
  3. 3.
    Grant RM, Lama JR, Anderson PL, McMahan V, Liu AY, Vargas L, et al. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med. 2010;363(27):2587–99.PubMedCrossRefGoogle Scholar
  4. 4.
    Baeten JM, Donnell D, Ndase P, Mugo NR, Campbell JD, Wangisi J, et al. Antiretroviral prophylaxis for HIV prevention in heterosexual men and women. N Engl J Med. 2012;367(5):399–410.PubMedCrossRefGoogle Scholar
  5. 5.
    Thigpen MC, Kebaabetswe PM, Paxton LA, Smith DK, Rose CE, Segolodi TM, et al. Antiretroviral preexposure prophylaxis for heterosexual HIV transmission in Botswana. N Engl J Med. 2012;367(5):423–34.PubMedCrossRefGoogle Scholar
  6. 6.
    Van Damme L, Corneli A, Ahmed K, Agot K, Lombaard J, Kapiga S, et al. Preexposure prophylaxis for HIV infection among African women. N Engl J Med. 2012;367(5):411–22.PubMedCrossRefGoogle Scholar
  7. 7.
    Microbicide trials network statement on decision to discontinue use of oral Tenofovir tablets in VOICE, a major HIV prevention study in women.: microbicide trials network; 2011 [4/15/2012]; Available from:
  8. 8.
    Microbicide trials network statement on decision to discontinue use of Tenofovir gel in VOICE, a major HIV prevention study in women.: microbicide trials network; 2011 [4/15/2012]; Available from:
  9. 9.
    Saberi P, Dong BJ, Johnson MO, Greenblatt RM, Cocohoba JM. The impact of HIV clinical pharmacists on HIV treatment outcomes: a systematic review. Patient Preference Adherence. 2012;6:297–322.CrossRefGoogle Scholar
  10. 10.
    van der Straten A, Van Damme L, Haberer JE, Bangsberg DR. Unraveling the divergent results of pre-exposure prophylaxis trials for HIV prevention. AIDS. 2012;26(7):F13–9.PubMedCrossRefGoogle Scholar
  11. 11.
    Chisholm-Burns MA, Lee JK, Spivey CA, Slack M, Herrier RN, Hall-Lipsy E, et al. US pharmacists’ effect as team members on patient care systematic review and meta-analyses. Med Care. 2010;48(10):923–33.PubMedCrossRefGoogle Scholar
  12. 12.
    McDonald HP, Garg AX, Haynes RB. Interventions to enhance patient adherence to medication prescriptions: scientific review. JAMA. 2002;288(22):2868–79.PubMedCrossRefGoogle Scholar
  13. 13.
    Saberi P, Johnson MO. Technology-based self-care methods of improving antiretroviral adherence: a systematic review. PLoS ONE. 2011;6(11):e27533.PubMedCrossRefGoogle Scholar
  14. 14.
    Wagner GJ, Ryan GW. Relationship between routinization of daily behaviors and medication adherence in HIV-positive drug users. AIDS Patient Care STDS. 2004;18(7):385–93.PubMedCrossRefGoogle Scholar
  15. 15.
    Romano J, editor. PrEP 2: The next generation of drugs and technologies (Paper #69). In: 19th Conference on retroviruses and opportunistic infections. Seattle, WA; 2012.
  16. 16.
    Kelesidis T, Landovitz RJ. Preexposure prophylaxis for HIV prevention. Curr HIV/AIDS Rep. 2011;8(2):94–103.PubMedCrossRefGoogle Scholar
  17. 17.
    Gilchrist VJ, Stange KC, Flocke SA, McCord G, Bourguet CC. A comparison of the National Ambulatory Medical Care Survey (NAMCS) measurement approach with direct observation of outpatient visits. Med Care. 2004;42(3):276–80.PubMedCrossRefGoogle Scholar
  18. 18.
    Hallett TB, Baeten JM, Heffron R, Barnabas R, de Bruyn G, Cremin I, et al. Optimal uses of antiretrovirals for prevention in HIV-1 serodiscordant heterosexual couples in South Africa: a modelling study. PLoS Med. 2011;8(11):e1001123.PubMedCrossRefGoogle Scholar
  19. 19.
    Paltiel AD, Freedberg KA, Scott CA, Schackman BR, Losina E, Wang B, et al. HIV preexposure prophylaxis in the United States: impact on lifetime infection risk, clinical outcomes, and cost-effectiveness. Clin Infect Dis. 2009;48(6):806–15.PubMedCrossRefGoogle Scholar
  20. 20.
    Malik A, Abraham P, Malik N. Acute renal failure and fanconi syndrome in an AIDS patient on tenofovir treatment—case report and review of literature. J Infect. 2005;51(2):E61–5.PubMedCrossRefGoogle Scholar
  21. 21.
    Hall AM, Hendry BM, Nitsch D, Connolly JO. Tenofovir-associated kidney toxicity in HIV-infected patients: a review of the evidence. Am J Kidney Dis. 2011;57(5):773–80.PubMedCrossRefGoogle Scholar
  22. 22.
    Scherzer R, Estrella M, Li Y, Choi AI, Deeks SG, Grunfeld C, et al. Association of tenofovir exposure with kidney disease risk in HIV infection. AIDS. 2012;26(7):867–75.PubMedCrossRefGoogle Scholar
  23. 23.
    March K, Mak M, Louie SG. Effects of pharmacists’ interventions on patient outcomes in an HIV primary care clinic. Am J Health Syst Pharm. 2007;64(24):2574–8.PubMedCrossRefGoogle Scholar
  24. 24.
    Santschi V, Chiolero A, Burnand B, Colosimo AL, Paradis G. Impact of pharmacist care in the management of cardiovascular disease risk factors: a systematic review and meta-analysis of randomized trials. Arch Intern Med. 2011;171(16):1441–53.PubMedCrossRefGoogle Scholar
  25. 25.
    HIV/AIDS Programme. Guidance on pre-exposure oral prophylaxis (PrEP) for serodiscordant couples, men and transgender women who have sex with men at high risk of HIV: Recommendations for use in the context of demonstration projects. In: World Health Organization, editor. 2012.
  26. 26.
    Center for Disease Control and Prevention. CDC interim guidance on HIV pre-exposure prophylaxis. Atlanta, GA; 2012. Available from:
  27. 27.
    Abbas UL, Anderson RM, Mellors JW. Potential impact of antiretroviral chemoprophylaxis on HIV-1 transmission in resource-limited settings. PLoS ONE. 2007;2(9):e875.PubMedCrossRefGoogle Scholar
  28. 28.
    Golub SA, Kowalczyk W, Weinberger CL, Parsons JT. Preexposure prophylaxis and predicted condom use among high-risk men who have sex with men. J Acquir Immune Defic Syndr. 2010;54(5):548–55.PubMedCrossRefGoogle Scholar
  29. 29.
    Supervie V, Garcia-Lerma JG, Heneine W, Blower S. HIV, transmitted drug resistance, and the paradox of preexposure prophylaxis. Proc Natl Acad Sci USA. 2010;107(27):12381–6.PubMedCrossRefGoogle Scholar
  30. 30.
    Vissers DC, Voeten HA, Nagelkerke NJ, Habbema JD, de Vlas SJ. The impact of pre-exposure prophylaxis (PrEP) on HIV epidemics in Africa and India: a simulation study. PLoS ONE. 2008;3(5):e2077.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2012

Authors and Affiliations

  1. 1.University of CaliforniaSan FranciscoUSA
  2. 2.Kaiser PermanenteVallejoUSA

Personalised recommendations