RESEARCH ARTICLE: Awareness, knowledge and comfort of pharmacy students on pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) for HIV prevention




Awareness, Comfort, Knowledge, Pharmacy Student, Post Exposure Prophylaxis (PEP), Pre-Exposure Prophylaxis (PrEP)


Introduction: Pharmacists are uniquely qualified to promote Pre-Exposure Prophylaxis (PrEP) and Post Exposure Prophylaxis (PEP). The objective of this study was to measure pharmacy students’ awareness, knowledge, and comfort regarding PrEP and PEP in an urban setting.   

Methods: A 23-point questionnaire was distributed to pharmacy students between 2 May 2019 and 31 May 2019.  

Results: Eighty six pharmacy students responded to the survey. Most of them correctly identified FDA-approved regimens for PrEP and PEP.  Most students thought that a pharmacist or intern counselling patients on PrEP or PEP was beneficial; however, a minority felt confident counselling patients on PrEP or PEP. Students who met criteria for composite knowledge were significantly more likely to report confidence in counselling.   

Conclusion: Pharmacy students have strong awareness, but limited knowledge and comfort regarding PrEP and PEP. Results from the survey will be used to assess the learning needs of pharmacy students and inform future curricular changes.

Author Biographies

Jennifer Bhuiyan, St. John’s University, New York, United States

College of Pharmacy and Health Sciences

Nicole Bradley, St. John’s University, New York, United States

College of Pharmacy and Health Sciences

Yuman Lee, St. John’s University, New York, United States

College of Pharmacy and Health Sciences

John Michael Conry, St. John’s University, New York, United States

College of Pharmacy and Health Sciences


Ajzen I. The theory of planned behavior. (1991). Organ Behav and Hum Dec Process., 50(2):179-211.

Baeten JM, Donnell D, Ndase P, et al. (2012). Antiretroviral Prophylaxis for HIV Prevention in Heterosexual Men and Women. N Engl J Med.,367(5):399-410.

Beymer MR, Bolan RK, Flynn RP, et al. (2014). Uptake and repeat use of postexposure prophylaxis in a community-based clinic in Los Angeles, California. AIDS Res Hum Retroviruses.,30(9):848-855.

Blumenthal J, Jain S, Krakower D, et al. (2015). Knowledge is Power! Increased Provider Knowledge Scores regarding Pre-exposure Prophylaxis (PrEP) are Associated with Higher Rates of PrEP Prescription and Future Intent to Prescribe PrEP. AIDS Behav.,19(5):802-810.

Bratberg JP. Opioids, naloxone, and beyond: The intersection of medication safety, public health, and pharmacy. (2017). J Am Pharm Assoc.,57(2): S5-S7.

Broekhuis JM, Scarsi KK, Sayles HR, et al. (2018). Midwest pharmacists’ familiarity, experience, and willingness to provide pre-exposure prophylaxis (PrEP) for HIV. PLoS ONE., 13(11):e0207372.

Bryant J, Baxter L, Hird S. (2009). Non-occupational postexposure prophylaxis for HIV: a systematic review. Health Technol Assess.,13(14):iii, ix-x, 1-60.

Cardo, Denise, Culver DH, Ciesielski CA, et al. (1997). A Case–Control study of HIV seroconversion in health care workers after percutaneous exposure. N Engl J Med.,337:1485-1490.

CA SB-159, §4052 (2019). HIV: Preexposure and Postexposure Prophylaxis. Accessed 14 July 2020

Centers for Disease Control and Prevention (CDC). (June 2020). HIV in the United States and Dependent Areas. Retrieved 21 July 2020 from

Centers for Disease Control and Prevention (CDC). (June 10, 2020). Let's Stop HIV Together: Stand Together Against HIV Stigma. Retrieved 14 July 2020 from

Centers for Disease Control and Prevention (CDC). (June 4, 2020). PrEP. Retrieved 14 July 2020 from

Centers for Disease Control and Prevention (CDC). (October 29, 2019). Preventing New HIV Infections: Guidelines. Retrieved 15 July 2020 from

Centers for Disease Control and Prevention (CDC). Updated Guidelines for Antiretroviral Postexposure Prophylaxis After Sexual, Injection Drug Use, or Other Non-occupational Exposure to HIV- United States, 2016. Retrieved 14 July 2020 from

Choopanya K, Martin M, Suntharasamai P, et al. (2013). Antiretroviral prophylaxis for HIV infection in injecting drug users in Bangkok, Thailand (the Bangkok Tenofovir Study): a randomised, double-blind, placebo-controlled phase 3 trial. Lancet.,381(9883):2083-2090.

Food and Drug Administration (FDA). (October 3, 2019). FDA approves second drug to prevent HIV infection as part of ongoing efforts to end the HIV epidemic. Retrieved 14 July 2020 from

Gilead Advancing Access® program. Gilead's Advancing Access® Program is Here to Help You. Retrieved 14 July 2020 from

Godin G, Bélanger-Gravel A, Eccles M, Grimshaw J. (2008). Healthcare professionals’ intentions and behaviours: a systematic review of studies based on social cognitive theories. Implementation Sci.,3(1):36.

Grant RM, Lama JR, Anderson PL, et al. (2010). Pre-exposure Chemoprophylaxis for HIV Prevention in Men Who Have Sex with Men. N Engl J Med.,363(27):2587-2599.

Gregory, Nancy. (February 13, 2020). California Readies for Implementation of Historic Law Aimed at Curbing HIV. Retrieved 14 July 2020 from

Grohskopf LA, Chillag KL, Gvetadze R, et al. (2013). Randomized trial of clinical safety of daily oral tenofovir disoproxil fumarate among HIV-uninfected men who have sex with men in the United States. J Acquir Immune Defic Syndr.,64(1):79-86.

Hosek SG, Siberry G, Bell M, et al. (2013). The acceptability and feasibility of an HIV pre-exposure prophylaxis (PrEP) trial with young men who have sex with men. J Acquir Immune Defic Syndr.,62(4):447-456.

Irvine C, Egan KJ, Shubber Z, Van Rompay KKA, Beanland RL, Ford N. (2015). Efficacy of HIV postexposure prophylaxis: systematic review and meta-analysis of nonhuman primate studies. Clin Infect Dis.,60(suppl_3):S165-S169.

Kanny D, Jeffries IV W, Chapin-Bardales J, et al. (2017). Racial/ethnic disparities in HIV pre-exposure prophylaxis among men who have sex with men — 23 urban areas, 2017. MMWR Morb Mortal Wkly Rep. 2019;68(37):6.

Légaré F, Borduas F, Freitas A, et al. (2014). Development of a simple 12-item theory-based instrument to assess the impact of continuing professional development on clinical behavioral intentions. PLoS ONE., 9(3):e91013.

Marrazzo JM, Ramjee G, Richardson BA, et al. (2015). Tenofovir-Based Preexposure Prophylaxis for HIV Infection among African Women. N Engl J Med., 372(6):509-518.

Matyanga CMJ. The role of the pharmacist in pre-exposure prophylaxis. (2014). PP., 05(03):225-228.

Molina J-M, Capitant C, Spire B, et al. (2015). On-Demand Preexposure Prophylaxis in Men at High Risk for HIV-1 Infection. N Engl J Med.,373(23):2237-2246.

Murnane PM, Celum C, Mugo N, et al. (2013). Efficacy of pre-exposure prophylaxis for HIV-1 prevention among high-risk heterosexuals: subgroup analyses from a randomized trial. AIDS. 2013; 27(13):2155-2160.

New York City Department of Health and Mental Hygiene (NYCDOHMH) HIV Epidemiology Program. HIV Surveillance Annual Report, 2018. (November 2019). Retrieved 21 July 2020 from

New York State Department of Health (NYSDOH). (September 2018). PEP 4 HIV Prevention: Pharmacy Emergency Post-Exposure Prophylaxis for HIV Prevention. Retrieved 15 July 2020 from

New York State Education Department (NYSED). (February 28, 2017). NYS Pharmacy: FAQ: Limited (Intern) Permit. Retrieved 22 July 2020 from

Patel RR, Mena L, Nunn A, et al. (2017). Impact of insurance coverage on utilization of pre-exposure prophylaxis for HIV prevention. PLoS ONE.,12(5):e0178737.

Peterson L, Taylor D, Roddy R, et al. (2007). Tenofovir Disoproxil Fumarate for Prevention of HIV Infection in Women: A Phase 2, Double-Blind, Randomized, Placebo-Controlled Trial. PLoS Clin Trials.,2(5):e27.

Przybyla SM, Parks K, Bleasdale J, Sawyer J, Morse D. (2019). Awareness, knowledge, and attitudes towards human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) among pharmacy students. Curr Pharm Teach Learn.,11(4):352-360.

Scott JD, Abernathy KA, Diaz-Linares M, Graham KK, Lee JC. HIV clinical pharmacists – the US perspective. Farm Hosp., 2010;34(6):303-308.

Tanner MR. Pre-exposure Prophylaxis for Prevention of HIV Acquisition Among Adolescents: Clinical Considerations, 2020. (2020). MMWR Recomm Rep., 69(3): 1-12.

The National Alliance of State and Territorial AIDS Directors (NASTAD). (November 2, 2018). Retrieved 14 July 2020 from

Thigpen MC, Kebaabetswe PM, Paxton LA, et al. (2012). Antiretroviral Preexposure Prophylaxis for Heterosexual HIV Transmission in Botswana. N Engl J Med.,367(5):423-434.

Tseng A, Foisy M, Hughes CA, et al. (2012). Role of the pharmacist in caring for patients with HIV/AIDS: clinical practice guidelines. Can J Hosp Pharm.,65(2):125-145.

United States Department of Health and Human Services (DHHS). Ending the HIV Epidemic: Ready, Set, PrEP. Retrieved 14 July 2020 from

Unni EJ, Lian N, Kuykendall W. (2016). Understanding community pharmacist perceptions and knowledge about HIV pre-exposure prophylaxis (PrEP) therapy in a Mountain West state. J Am Pharm Assoc., 56(5):527-532.e1.

Van Damme L, Corneli A, Ahmed K, et al. (2012). Pre-exposure Prophylaxis for HIV Infection among African Women. N Engl J Med., 367(5):411-422.

Young, T, Arens FJ, Kennedy GE, et al. (2007). Antiretroviral post‐exposure prophylaxis (PEP) for occupational HIV exposure. Cochrane Database Syst Rev., Issue 1. Art. No.: CD002835.





Research Article