Abstract / Summary
Abstract Background HIV pre-exposure prophylaxis (PrEP) is highly effective at preventing HIV acquisition, but access and uptake in England remain unequal. Community pharmacies could broaden access, yet evidence on public awareness and acceptability of pharmacy-based PrEP in England is limited. Methods We analysed a cross-sectional online survey of 14,678 consenting adults recruited through NHS general practices in England, the National Institute for Health and Care Research (NIHR) Be Part of Research (BPoR) service, and professional and personal networks between 29 October 2022 and 29 October 2023. The questionnaire assessed PrEP awareness and use, interest in PrEP information, and attitudes towards pharmacy-based access. Outcomes were summarised descriptively and examined using multivariable logistic regression. Results Among 14,678 consenting respondents (mean age 47.6 years, SD 16.1; 55.4% female; 78.1% heterosexual; 82.5% White), 35.5% reported having heard of PrEP and 32.4% reported prior awareness that PrEP can prevent HIV. Current and previous PrEP use were reported by 1.8% and 1.2%, respectively, and 63.1% expressed interest in seeking PrEP information. Overall, 52.1% agreed or strongly agreed that they would be happy to obtain PrEP from a local pharmacy, 64.2% were comfortable obtaining PrEP information there, and 52.2% gave pharmacy the highest convenience score (5/5). In adjusted analyses, prior awareness was lower among Asian than White respondents (aOR 0.64, 95% CI 0.55–0.75). Support for pharmacy access was higher among respondents aged <25 versus ≥65 years (aOR 2.31, 95% CI 1.95–2.73), and among bisexual (aOR 2.40, 95% CI 2.07–2.79), homosexual (aOR 3.18, 95% CI 2.73–3.69) and pansexual respondents (aOR 2.00, 95% CI 1.47–2.73) versus heterosexual respondents. Conclusions PrEP awareness was limited in this large non-probability sample, while interest in PrEP information and acceptability of pharmacy-linked access were substantial. The findings support evaluation of pharmacy-linked PrEP awareness, referral and access pathways alongside targeted communication. Because the sample was not nationally representative and clinical PrEP eligibility was not measured, population prevalence and unmet clinical need cannot be inferred.