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: Introduction: Pre‐exposure prophylaxis (PrEP) is an effective medication to reduce the risk of acquiring HIV. PrEP is available free of charge in the UK from sexual health clinics. Expanding PrEP delivery to community pharmacies holds promise and aligns with UK government goals to eliminate new cases of HIV by 2030. The aim of this scoping review was to describe the existing evidence about the barriers to and facilitators of community pharmacy oral PrEP delivery, for pharmacists and pharmacy clients, as aligned with the Capacity Opportunity, Motivation Behaviour (COM‐B) Model. Methods: Five bibliographic and five review databases were searched from inception to August 2023. Literature of any study design was included if it discussed barriers and facilitators of community pharmacy PrEP delivery. Trial registrations, protocols and news articles were excluded. Results: A total of 649 records were identified, 73 full texts were reviewed and 56 met the inclusion criteria, predominantly from high‐income/westernized settings. Most of the included literature was original research (55%), from the United States (77%) conducted during or after the year 2020 (63%). Barriers to PrEP delivery for pharmacists included lack of knowledge, training and skills (capability), not having the necessary facilities (opportunity), concern about the costs of PrEP and believing that PrEP use could lead to risk behaviours and sexually transmitted infections (motivation). Facilitators included staff training (capability), time, the right facilities (opportunity), believing PrEP could be a source of profit and could reduce new HIV acquisitions (motivation). For clients, barriers included a lack of PrEP awareness (capability), pharmacy facilities (opportunity) and not considering pharmacists as healthcare providers (motivation). Facilitators included awareness of PrEP and pharmacist's training to deliver it (capability), the accessibility of pharmacies (opportunity) and having an interest in PrEP (motivation). Discussion: To effectively enhance oral PrEP delivery in UK community pharmacies, the identified barriers and facilitators should be explored for UK relevance, addressed and leveraged at the pharmacy team, client and care pathway level. Conclusions: By comprehensively considering all aspects of the COM‐B framework, community pharmacies could become crucial providers in expanding PrEP accessibility, contributing significantly to HIV prevention efforts., INTRODUCTION The human immunodeficiency virus (HIV) epidemic remains a significant public health concern worldwide. In 2021, it was estimated that there were 105,200 people living with HIV in the UK, [...]

Objectives: Expanding delivery of oral pre-exposure prophylaxis (PrEP) to community pharmacies could improve access, aligning well with the UK government's goals to eliminate new HIV acquisitions by 2030. Using the Capability, Opportunity, Motivation, Behaviour (COM-B) model for behaviour change, the aim of this research was to explore the barriers and facilitators of community pharmacy PrEP delivery, for pharmacists and community members., Methods: Community members at elevated risk of acquiring HIV and community pharmacists were recruited to participate in semi-structured interviews. Interviews were recorded, transcribed, and thematically analysed within the framework of the COM-B model., Results: 17 interviews with pharmacists (pharmacy owners n=7; employed pharmacists n=6; locums n=4) and 24 with community members (black African women n=6; other women n=2; young adults aged 18-25 years n=6; transgender people n=6; female sex workers n=4) were carried out. Capability barriers included suboptimal awareness and knowledge of PrEP, pharmacy facilities and pharmacist roles in delivering public health services. Opportunity barriers included a lack of staff capacity, privacy and pharmacy screening and monitoring facilities. Motivational barriers included a concern that increased access could increase sexually transmitted infections and involve a financial cost. Capability facilitators included awareness raising, HIV and PrEP training and education. Opportunity facilitators included PrEP appointments and the accessibility of pharmacies. Motivational facilitators included a preference for pharmacy delivery over other models (eg, sexual health, General Practitioner (GP)), and a belief that it would be discrete and less stigmatising., Conclusion: Pharmacy PrEP delivery is acceptable but for it to be feasible, results point to the need for the development of a behaviour change intervention focusing on education, training and awareness raising, targeting pharmacists and community members to stimulate patient activation and de-stigmatise HIV. This intervention would need to be facilitated by system and environmental changes (eg, commissioning service)., Competing Interests: Competing interests: RH-S is an employee of Gilead Sciences., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)