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Peer-reviewedCC BY 4.0PLOS One

Stakeholder-informed pre-implementation refinement of a pharmacy-led pre-exposure prophylaxis (PrEP) service delivery model in Malaysia

  • Yan Nee Gan1
  • Sin How Lim2
  • Frederick L. Altice3
  • Sharifah Khadijah Syed Razif4
  • Mariani Ahmad Nizaruddin5
  • Reena Rajasuriar6
  • Sazali Basri7
  • Joselyn Pang8
  • Andrew Yap9
  • Iskandar Azwa10
  • Rafdzah Zaki11
11 affiliations
  1. 1Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
  2. 2Malaysian Health Technology Assessment Section (MaHTAS), Ministry of Health, Putrajaya, Malaysia
  3. 3Centre of Excellence for Research in Infectious Diseases and AIDS (CERiA), Universiti Malaya, Kuala Lumpur, Malaysia
  4. 4Section of Infectious Disease, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, United States of America
  5. 5Division of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America
  6. 6Center for Interdisciplinary Research on AIDS (CIRA), Yale University, New Haven, Connecticut, United States of America
  7. 7Department of Community and Pharmacy Practice, Faculty of Pharmacy, University of Cyberjaya, Cyberjaya, Selangor, Malaysia
  8. 8Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
  9. 9Infectious Diseases Unit, Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
  10. 10The Red Clinic, Petaling Jaya, Selangor, Malaysia
  11. 11Centre for Epidemiology and Evidence-Based Practice (CEBP), Universiti Malaya, Kuala Lumpur, Malaysia
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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.

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Cite

BibTeXRIS
BibTeX
@article{gan2026stakeholderinformed,
  title = {{Stakeholder-informed pre-implementation refinement of a pharmacy-led pre-exposure prophylaxis (PrEP) service delivery model in Malaysia}},
  author = {Yan Nee Gan and Sin How Lim and Frederick L. Altice and Sharifah Khadijah Syed Razif and Mariani Ahmad Nizaruddin and Reena Rajasuriar and Sazali Basri and Joselyn Pang and Andrew Yap and Iskandar Azwa and Rafdzah Zaki},
  journal = {PLOS One},
  year = {2026},
  month = sep,
  doi = {10.1371/journal.pone.0357920},
  url = {https://doi.org/10.1371/journal.pone.0357920},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Stakeholder-informed pre-implementation refinement of a pharmacy-led pre-exposure prophylaxis (PrEP) service delivery model in Malaysia
AU  - Yan Nee Gan
AU  - Sin How Lim
AU  - Frederick L. Altice
AU  - Sharifah Khadijah Syed Razif
AU  - Mariani Ahmad Nizaruddin
AU  - Reena Rajasuriar
AU  - Sazali Basri
AU  - Joselyn Pang
AU  - Andrew Yap
AU  - Iskandar Azwa
AU  - Rafdzah Zaki
PY  - 2026
DA  - 2026/09/08
JO  - PLOS One
DO  - 10.1371/journal.pone.0357920
UR  - https://doi.org/10.1371/journal.pone.0357920
AB  - 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.
SN  - 1932-6203
ER  -