Objective 2.1 million people worldwide, including 40,000 Americans become infected with HIV each year. As medication experts and healthcare professionals that are very accessible to patients, pharmacists are well positioned to conduct HIV prevention activities including promotion of pre-exposure prophylaxis (PrEP) and providing access to sterile syringes to people who inject drugs (PWIDs). There is a paucity of research examining pharmacists’ attitudes about providing HIV prevention services to at-risk populations. We examined pharmacists’ perceptions in engaging in HIV -related counselling, condom use and PrEP.

Methods We asked 225 pharmacists from 41 US states questions about their comfort-level counselling on: 1) HIV/AIDS, 2) condom use, 3) clean needles to PWIDs and 4) PrEP use; interacting with HIV-positive 5) MSMs and 6) heterosexuals; and 7) selling needles to PWIDs. We ran individual generalised linear modelling (GLM) regressions for each question, and report our findings below.

Results Of 225 participants, nearly half (41%) worked in the top HIV counties where the vast majority of PLWH reside. Pharmacists were mostly female (63%), and Caucasian (66%). Most were HIV-certified (68%); 31% worked in specialty-only and 21% in traditional-only pharmacies. Majority were comfortable discussing HIV (91%), condom use (91%), and counselling PLWH who were heterosexual (96%) or MSM (97%). However, 33% were uncomfortable selling PWIDs needles and 48% teaching PWIDs to use clean needles. HIV-certified pharmacists were twice as likely to be comfortable selling PWIDs needles (OR_sellneedles 2.46; p < 0.001) than condom use counselling (OR_{counselcondomuse} 1.10; p < 0.001). Pharmacist comfort-level discussing HIV increased by 2% with age.

Conclusion Our finding that a significant proportion of pharmacists were uncomfortable serving PWIDs is concerning given that pharmacists might have frequent encounters with this hard-to-reach vulnerable population. Continuing professional education (CPE) curricula should be expanded to improve pharmacists’ ability and comfort serving populations at high-risk for HIV.

Disclosure statement This study was funded by the National Institutes of Mental Health, U. S. A. No pharmaceutical grants were received in the development of this study.