Role of pharmacists in HIV prophylaxis: a scoping review of pharmacists' services, interventions and outcomes.

introductionHIV remains a major global public health challenge, with nearly 1.3 million new HIV acquisitions annually. Despite the effectiveness of pre-exposure (PrEP) and post-exposure prophylaxis (PEP), barriers to access, initiation and adherence persist. Pharmacists, as accessible healthcare providers with medication expertise, are increasingly involved in HIV prevention. However, the scope and impact of pharmacist-led prophylaxis services have not been comprehensively synthesized. This study aimed to map and characterize the existing evidence on pharmacists' services, interventions and outcomes in HIV prophylaxis.

methodsA scoping review was conducted with searches in Medline (PubMed), Embase, Scopus and LILACS, supplemented by grey literature (Google Scholar) until May 2025. Eligible studies included original research describing pharmacist-led clinical activities or interventions related to HIV prophylaxis. Two independent reviewers conducted study selection and data extraction. Pharmacists' roles were categorized based on the International Pharmaceutical Federation (FIP) and the Descriptive Elements of Pharmacist Intervention Characterization Tool (DEPICT) Version 2. The impacts of pharmacists on outcomes of care were categorized considering economic, clinical, humanistic and process-related outcomes.

resultsOut of 2736 records retrieved from searches, 26 studies published between 2014 and 2025 were included, which were conducted predominantly in the United States (n = 21). Pharmacists commonly performed direct patient care (e.g. patient counselling, PrEP/PEP prescribing, adherence monitoring, laboratory tests ordering), facilitated medication access and collaborated with other healthcare professionals via different communication methods (face-to-face, telephone, written, videoconference), especially in primary care and community pharmacies. Pharmacists' autonomy to prescribe and order laboratory tests was observed in several studies under both independent and collaborative practice models. Twenty studies reported positive process outcomes, such as increased PrEP initiation, adherence and retention, while fewer assessed clinical (n = 8), economic (n = 2) or humanistic (n = 1) outcomes. DISCUSSION: Expanding pharmacist-led services, particularly in underserved regions, represents a promising strategy to improve access, initiation and adherence to HIV prevention. Future research on economic and patient-centred outcomes is needed to inform integration of pharmacists into HIV prevention strategies.

conclusionsPharmacists play a growing and multifaceted role in HIV prophylaxis across diverse healthcare settings. Evidence supports the expansion of pharmacist-led models through enabling legislation, reimbursement policies and interprofessional collaboration.