{ "abstract": "Introduction: In 2024, only 3,451 individuals accessed free oral HIV pre-exposure prophylaxis (PrEP) at government clinics in Malaysia, despite an estimated 354,000 key population members who could benefit from PrEP. To inform pre-implementation refinement of a pharmacy-led PrEP service delivery model, we explored stakeholder perspectives on implementing the model within private community pharmacies in Malaysia. Materials and methods: A one-day stakeholder consultation was conducted in April 2023 in Kuala Lumpur with 28 stakeholders representing community pharmacies, professional societies, telemedicine providers, non-governmental organizations (NGOs), and HIV implementation science researchers. The meeting began with a review of preliminary findings from formative qualitative research involving key populations, community pharmacists, and PrEP prescribers. Through facilitated discussions, stakeholders identified short- and long-term solutions to implementation barriers. Stakeholder inputs from discussions and structured worksheets were synthesized descriptively to identify recurring implementation considerations that informed refinement of the pilot model. Results: Key implementation considerations included enhancing awareness and demand generation, ensuring privacy, confidentiality, and affordability, integrating HIV self-testing, using digital checklist-based assessments, simplifying laboratory testing requirements, developing practical workflows supported by a reference guide, strengthening pharmacist training, and fostering cross-sector collaboration. Identified training needs included PrEP fundamentals, eligibility assessment for initiation and continuation, referral procedures, and scenario-based learning. Key competencies included knowledge of HIV and sexually transmitted infections, risk assessment, professional conduct, and person-centered communication. Six study sites were selected, with preparation requirements including HIV self-test kits, PrEP medications, informational materials, trained pharmacists, telemedicine subscriptions, and nearby referral clinics. The consultation informed refinements to the implementation plan. Conclusions: This stakeholder consultation informed refinement of a pharmacy-led PrEP service delivery model for pilot implementation in Malaysia and identified practical implementation considerations related to privacy, affordability, HIV self-testing, physician-pharmacist coordination, training, and referral systems. The findings may inform future implementation planning for similar urban, private-sector PrEP delivery models.", "abstract_shown": true, "affiliations": [ "Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia", "Malaysian Health Technology Assessment Section (MaHTAS), Ministry of Health, Putrajaya, Malaysia", "Centre of Excellence for Research in Infectious Diseases and AIDS (CERiA), Universiti Malaya, Kuala Lumpur, Malaysia", "Section of Infectious Disease, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, United States of America", "Division of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America", "Center for Interdisciplinary Research on AIDS (CIRA), Yale University, New Haven, Connecticut, United States of America", "Department of Community and Pharmacy Practice, Faculty of Pharmacy, University of Cyberjaya, Cyberjaya, Selangor, Malaysia", "Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia", "Infectious Diseases Unit, Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia", "The Red Clinic, Petaling Jaya, Selangor, Malaysia", "Centre for Epidemiology and Evidence-Based Practice (CEBP), Universiti Malaya, Kuala Lumpur, Malaysia" ], "article_type": "Research Article", "arxiv": null, "author_total": 11, "authors": [ { "affs": [ 0 ], "name": "Yan Nee Gan" }, { "affs": [ 1 ], "name": "Sin How Lim" }, { "affs": [ 2 ], "name": "Frederick L. Altice" }, { "affs": [ 3 ], "name": "Sharifah Khadijah Syed Razif" }, { "affs": [ 4 ], "name": "Mariani Ahmad Nizaruddin" }, { "affs": [ 5 ], "name": "Reena Rajasuriar" }, { "affs": [ 6 ], "name": "Sazali Basri" }, { "affs": [ 7 ], "name": "Joselyn Pang" }, { "affs": [ 8 ], "name": "Andrew Yap" }, { "affs": [ 9 ], "name": "Iskandar Azwa" }, { "affs": [ 10 ], "name": "Rafdzah Zaki" } ], "bibtex": "https://research.draconitic.com/paper/1sq0d59g2wfeq.bib", "cited_by": 0, "doi": "10.1371/journal.pone.0357920", "fulltext_url": null, "id": "1sq0d59g2wfeq", "issns": [ "1932-6203" ], "landing_url": "https://doi.org/10.1371/journal.pone.0357920", "language": null, "licence": "CC-BY-4.0", "licence_label": "CC BY 4.0", "licence_source": "journal", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [ [ "openalex", "2725|HIV/AIDS Research and Interventions" ], [ "plos", "/Biology and life sciences/Microbiology/Medical microbiology/Microbial pathogens/Viral pathogens/Immunodeficiency viruses/HIV" ], [ "plos", "/Biology and life sciences/Microbiology/Medical microbiology/Microbial pathogens/Viral pathogens/Retroviruses/Lentivirus/HIV" ], [ "plos", "/Biology and life sciences/Organisms/Viruses/Immunodeficiency viruses/HIV" ], [ "plos", "/Biology and life sciences/Organisms/Viruses/RNA viruses/Retroviruses/Lentivirus/HIV" ], [ "plos", "/Biology and life sciences/Organisms/Viruses/Viral pathogens/Immunodeficiency viruses/HIV" ], [ "plos", "/Biology and life sciences/Organisms/Viruses/Viral pathogens/Retroviruses/Lentivirus/HIV" ], [ "plos", "/Medicine and health sciences/Diagnostic medicine/Virus testing" ], [ "plos", "/Medicine and health sciences/Health care/Health care providers/Physicians" ], [ "plos", "/Medicine and health sciences/Health care/Medical services/Telemedicine" ], [ "plos", "/Medicine and health sciences/Pathology and laboratory medicine/Pathogens/Microbial pathogens/Viral pathogens/Immunodeficiency viruses/HIV" ], [ "plos", "/Medicine and health sciences/Pathology and laboratory medicine/Pathogens/Microbial pathogens/Viral pathogens/Retroviruses/Lentivirus/HIV" ], [ "plos", "/Medicine and health sciences/Pharmaceutics/Drug delivery" ], [ "plos", "/Medicine and health sciences/Pharmacology/Drug research and development/Drug regulation" ], [ "plos", "/Medicine and health sciences/Public and occupational health/Preventive medicine/Prophylaxis/Pre-exposure prophylaxis" ], [ "plos", "/People and places/Population groupings/Professions/Medical personnel/Pharmacists" ], [ "plos", "/People and places/Population groupings/Professions/Medical personnel/Physicians" ] ], "openalex": "W7211931476", "pdf_url": null, "pmcid": null, "pmid": null, "published": "2026-09-08", "publisher": "Public Library of Science", "ris": "https://research.draconitic.com/paper/1sq0d59g2wfeq.ris", "sources": [ { "first_seen": "2026-10-30T12:17:56Z", "native_id": "10.1371/journal.pone.0357920", "source": "plos", "url": "https://doi.org/10.1371/journal.pone.0357920" } ], "subjects": [ { "field": "biology", "origin": "plos:microbiology", "subfield": "microbiology" }, { "field": "medicine", "origin": "plos:public and occupational health", "subfield": "epidemiology-public-health" }, { "field": "medicine", "origin": "plos:pharmacology", "subfield": "pharmacology-toxicology" } ], "title": "Stakeholder-informed pre-implementation refinement of a pharmacy-led pre-exposure prophylaxis (PrEP) service delivery model in Malaysia", "title_text": "Stakeholder-informed pre-implementation refinement of a pharmacy-led pre-exposure prophylaxis (PrEP) service delivery model in Malaysia", "type": "peer-reviewed", "updated_at": "2026-10-30T12:17:56Z", "url": "https://research.draconitic.com/paper/1sq0d59g2wfeq", "venue": "PLOS One", "versions": [] }