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Commentary|Videos|September 28, 2026
Pharmacies Can Close HIV Awareness Gap in Youth: Kevin Astle, PharmD
Fact checked by: Laura Joszt, MA
Kevin Astle, PharmD, on how pharmacies can reach young men unaware of their HIV status and why step therapy limits PrEP.
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Young men aged 13 to 24 with HIV are more likely to be unaware of their HIV status than men in other age groups. Among gay and bisexual men more broadly, challenges such as racism, discrimination, and stigma contribute to the disproportionate impact of HIV.1
Pharmacies may be one way to close that gap, Kevin Astle, PharmD, BCPS, BCACP, AAHIVP, CDCES, assistant professor in the Department of Pharmacotherapeutics and Clinical Research at the University of South Florida Taneja College of Pharmacy, said in an interview with The American Journal of Managed Care®. Marketing the testing and prevention options available at pharmacies, including pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis, can help build trust with younger patients and empower them to know their status, he said.
"When we think about that testing, we see pharmacies are being able to provide expanding testing and treatment services directly in the pharmacies, and this can really help expand that awareness," Astle said.
Access to newer options remains a hurdle. Some insurers require step therapy, meaning patients must fail oral PrEP before long-acting injectable PrEP is covered. Failing oral PrEP generally means a patient has been put at increased risk for HIV, Astle said, and some patients cannot take oral options because of kidney or bone mineral density concerns. He wants to see insurers cover all forms of PrEP without step therapy.
"The cost for the medications may seem high up front, but really when we look at the cost of any new HIV infections, from a monetary perspective, it's going to be extremely more expensive," he said.
Young patients face an added barrier: if they are on a parent's insurance plan, even an HIV test can show up on that plan, forcing difficult conversations about disclosure.
"Any ways that we can have pharmacies work to empower patients and empower families to want to have these conversations early and proactively is really what's needed," he said.
References
1. National Gay Men's HIV/AIDS Awareness Day, September 27. NIH. Accessed September 28, 2026.
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