PSQ2 – HIV PrEP – addressing and ensuring safety

Link to EAHP Statements
Section 4 – Clinical Pharmacy: Statements – 4.6, 4.7, 4.8
Section 5 – Patient Safety and Quality Assurance: Statements – 5.1, 5.2, 5.3, 5.4

Abstract
Pre-exposure Prophylaxis (PrEP) has revolutionized HIV prevention, offering a highly effective strategy to reduce transmission. However, access to PrEP remains deeply unequal, with disparities driven by socioeconomic factors, geographic location, systemic barriers, and stigma. This seminar will explore the role of hospital pharmacists in addressing these inequalities, ensuring that PrEP reaches all individuals who could benefit from it, regardless of background or circumstances.
PrEP is not just a biomedical intervention but a tool for empowerment—yet structural inequities limit its accessibility, particularly among marginalized communities, including individuals from lower-income backgrounds, migrants, ethnic minorities, and those facing discrimination based on gender identity or sexual orientation. Stigma, limited healthcare literacy, and gaps in service integration further exacerbate these disparities, hindering equitable uptake.
Beyond access, ensuring PrEP safety and effectiveness requires addressing adherence challenges, which can be influenced by cultural, social, and economic factors. Hospital pharmacists play a key role in developing person-centered strategies to improve adherence while mitigating risks such as emerging drug resistance, side effects, and the increased prevalence of other sexually transmitted infections (STIs).
Diversity in PrEP users also calls for tailored approaches in care and communication, recognizing that one-size-fits-all solutions are insufficient. Hospital pharmacists, as medication experts embedded within healthcare systems, are essential in bridging gaps, advocating for inclusive policies, and ensuring that innovations in HIV prevention are accessible, safe, and sustainable for all individuals, not just those with the easiest access to care.
This seminar will provide insights into the intersection of HIV prevention, diversity, and health equity, equipping participants with practical strategies to enhance PrEP access and safety while promoting a more inclusive and effective approach to HIV prevention.

Learning objectives
After the session, the participant should be able to:
– Analyze the safety profiles of PrEP, especially related to adherence concerns.
– Identify and address health inequalities in PrEP access.
– Evaluate the risks and benefits associated with the broader use of PrEP, including drug resistance, side effects and the possible increase of STIs.
– Discuss the sustainability challenges posed by emerging treatments (e.g. long-acting therapies).

Educational need addressed
After the session, the participant should be able to understand the safety profiles and adherence challenges associated with HIV PrEP, recognizing the critical role of therapeutic adherence in ensuring efficacy and minimizing risks such as drug resistance and adverse events. They will gain insights into the pharmacist’s responsibilities in addressing these complexities, including optimizing therapy, promoting individual-centered care, and mitigating potential risks. Furthermore, participants will be equipped to evaluate the economic and ethical implications of novel therapies, ensuring their sustainable and equitable integration into HIV prevention strategies.

Keywords
Human immunodeficiency Virus (HIV), Adherence, Safety, Sexually Transmitted Diseases, Polypharmacy.