Gulf South · HIV Prevention · Pharmacy-based access

Widening the circle of who can safely deliver PrEP.

A multi-year research program at Xavier University of Louisiana — moving HIV prevention from specialist clinics to the primary-care providers and community pharmacists who already sit at the front door of underserved communities.

Illustration of a pharmacist consulting with a young adult about PrEP in a community pharmacy
PrEP conversations can happen where patients already receive care. Illustrative image created for XULA Voice. The people shown are not real patients and the image does not represent any individual’s PrEP use.
87.6%
of PrEP patients retained in care — with no difference between specialist and primary-care providers once adjusted.
2019 cohort · n=216
67%
of surveyed Louisiana community pharmacies already serve patients seeking PrEP or PEP.
2024–25 needs assessment · n=52
75%
of surveyed pharmacists hold positive attitudes toward prescribing PrEP — the Louisiana pharmacy workforce is willing.
2025–26 willingness study · n=86
New · 2024 Louisiana law now authorizes pharmacists to furnish PrEP — Act 711. The authority already exists — the workforce is ready to be trained.
The research arc

One question, told in three chapters.

Widening access to PrEP starts with widening who can provide it. These three studies ask — and answer — whether that circle can grow while keeping patients in care.

2019 · PUBLISHED
The proof

Provider type & retention

Retrospective cohort at a New Orleans FQHC comparing infectious-disease specialists with primary-care providers on keeping PrEP patients in care.

Finding: The apparent specialist advantage disappeared after adjustment (aOR 0.88). PCPs retain patients just as well.
n = 216 patients · 15 providers
2024–25 · IN PREPARATION
The opportunity

Pharmacy readiness

Statewide needs assessment of community pharmacists: who already stocks PrEP, who serves these patients, and which languages they speak.

Finding: Pharmacies are already an access point — 81% stock oral PrEP — but injectable PrEP reaches only 10%.
n = 52 completed responses
2025–26 · UNDER REVIEW
The lever

Pharmacist willingness

Knowledge, attitudes, confidence and barriers among community pharmacists — most working in high HIV-incidence regions of the Deep South.

Finding: Willing and positive, and ready to be trained — focused education is all that stands between this workforce and delivering PrEP (28% currently pass a rapid knowledge check).
n = 86 pharmacists

Evidence in detail

What the data show.

Every figure below is drawn from primary study data conducted by xulavoice.com, housed in Xavier University of Louisiana's College of Pharmacy. Sample sizes are stated on each panel; the pharmacist studies are response-driven samples concentrated in Louisiana and the Gulf South.

Figure 1 · 2019 cohort · n=216

The specialist advantage is a mirage

Odds of retention for ID specialists vs. primary-care providers — before and after adjusting for age, race, and risk. When confounders are controlled, provider type stops predicting who stays in care.

Read it this way: an odds ratio of 1.0 means "no difference." The unadjusted gap (7.5) collapses to 0.88 after adjustment — statistically indistinguishable from no effect. The same happens for race. Translation for expansion: outcomes don't depend on the specialty of the prescriber.
Figure 2 · 2019 cohort · n=216

Retention in care

Follow-up captured across the first six months of PrEP.

88% of patients returned for at least one visit; nearly half completed both the 3- and 6-month checkpoints recommended by CDC.
Figure 3 · 2024–25 assessment · n=52

Pharmacies are already stocked

Share of surveyed pharmacies offering each service.

Oral PrEP and HIV therapy are widely available — injectable PrEP (Apretude) is the clear gap at just 10%.
Figure 4 · 2025–26 study · n=86

Willing and positive — and ready to be trained

The readiness picture in a single view. Attitudes and perceived importance already run high; formal knowledge and training are where focused investment pays off — exactly what a training-and-implementation partnership delivers.

The opportunity: the will is already there — what remains is capability, and capability is teachable. Most pharmacists have not yet completed recent PrEP training, and fewer than one in three currently pass a knowledge check — a highly closable gap that XULA Voice is uniquely positioned to close through targeted continuing education and workforce training.
Figure 5 · 2025–26 study · n=86

What's standing in the way

Perceived barriers to prescribing PrEP, ranked by mean rating (higher = greater barrier). Notably, belief-based objections ranked among the lowest measured — the obstacles here are practical and operational, not attitudinal.

The top barriers — clinical/lab monitoring, training, and staffing — are all addressable through protocol design, continuing education, and workflow support: exactly the tools XULA Voice is built to provide.
The case for the next phase

The evidence points to one intervention.

Seven years of data converge on a single, fundable conclusion. The 2019 outcomes study established that expanding PrEP beyond infectious-disease specialists does not cost patients their retention in care — primary-care providers perform equivalently once you adjust for who their patients are.

The 2024–25 needs assessment showed that community pharmacies are already positioned to be the next link in that chain: two-thirds serve PrEP patients, most stock the medication, and many speak the languages of the communities most affected.

The 2025–26 willingness study located the one missing piece. Pharmacists want to prescribe and see it as responsible care — the one thing between intent and action is training, the most solvable barrier of all. The legal pathway, meanwhile, is already open: since 2024, Louisiana's Act 711 authorizes pharmacists to furnish PrEP. That gap is the opportunity — and it's what XULA Voice was built to close. Housed at Xavier University of Louisiana — the nation's leading producer of Black pharmacists — XULA Voice is positioned to deliver that training, bringing a ready, trusted, geographically distributed workforce online in exactly the high-incidence communities where the epidemic persists.

Rooted in community

Communities are our partners — grounded in a century of trust.

XULA Voice practices community-engaged, participatory research — communities are our partners at every step, from shaping the questions to sharing what we learn. That partnership is built on Xavier's century of roots in the same New Orleans communities we serve, so a pharmacist-delivered PrEP program reaches people through the faith and community organizations they already know and trust.

People having supportive conversations in a CDC Talk HIV campaign image
Open, stigma-free conversations make HIV prevention easier to reach. CDC · Let’s Stop HIV Together, Talk HIV. Source. The image is illustrative and does not identify anyone’s HIV status or PrEP use.
Trusted messengers

Embedded in local partners

We meet people where they already gather — in faith and social centers and neighborhood organizations across New Orleans — so health information arrives through voices the community already trusts.

Capacity that stays

Community health workers & students

We train community health workers and Xavier pharmacy students in research skills, cultural competence, and communication — building prevention capacity that remains long after a study ends.

No language left out

Multilingual by design

Our team and partner pharmacies reach residents in Spanish, Vietnamese, and Arabic, so language is never the barrier standing between someone and prevention.

50+
community partners we engage through Xavier's College of Pharmacy Health & Wellness Center
300+
pharmacies across Louisiana reachable through our Professional Experience Program
Who's behind this

An HBCU-anchored pharmacy research team.

Grounded at Xavier University of Louisiana — the nation's leading producer of Black pharmacists — and built on decades of community-engaged research across the Gulf South.

A diverse group of young adults walking together in a CDC college-focused HIV prevention campaign
Young adults and students are central to the next generation of HIV prevention. CDC · Together U: We Are the Generation. Source. The image is illustrative and does not identify anyone’s HIV status or PrEP use.
Sara Al-Dahir, PharmD, PhD, MPH, BCPS
Principal investigator · Founder, XULA Voice

Clinical Professor in Xavier's College of Pharmacy and principal investigator of XULA Voice. An infectious-disease pharmacist (BCPS) holding a PharmD from Xavier, an MPH in epidemiology from Tulane, and a PhD in international health from Johns Hopkins, she is a former Fulbright Scholar whose research centers on vaccine access, equity, and the disproportionate impact of infectious disease on marginalized communities. She has led community-engaged, faith-based prevention studies funded by Genentech, the NIH/NIMHD, and Pfizer, and has consulted for the WHO and UNICEF.

Daniel F. Sarpong, PhD
Biostatistics & study design

Doctoral-trained biostatistician, Executive Director of the Office of Health Equity Research at Yale School of Medicine, and a former tenured professor at Xavier University of Louisiana. He is Multiple PI of the national RCMI Coordinating Center — a network of 23 NIH-funded institutions — and served as Director and Co-PI of the $50-million Jackson Heart Study, the benchmark longitudinal cardiovascular study in African Americans. He brings three decades of study design, program evaluation, and health-equity methodology to XULA Voice.

William Kirchain, PharmD
Law & regulatory · Board of Pharmacy liaison

Directs Xavier's College of Pharmacy Health & Wellness Center — a community-based practice offering free chronic-disease screenings, medication check-ups, smoking-cessation coaching, and diabetes and healthy-cooking classes. As XULA Voice's law-and-regulatory specialist and Board of Pharmacy liaison, he teaches pharmacy law at Xavier and has served as President of the Louisiana Pharmacists Association and Vice Chair of the Louisiana Board of Medical Examiners' Advisory Committee for Collaborative Practice. He was at the forefront of creating Louisiana's pharmacist PrEP law — Act 711 (House Bill 579, 2024), which authorizes pharmacists to dispense up to a 30-day supply of PrEP and a 28-day supply of PEP. The legal foundation for pharmacist-delivered PrEP in Louisiana already exists — and a member of this team helped write it.

John Okogbaa, PharmD, MEd
Director, Professional Experience Program

Directs Xavier's Professional Experience Program, coordinating student placements and clinical partnerships across more than 300 pharmacies statewide — a ready-built network for training pharmacists and rolling out pharmacist-delivered PrEP across Louisiana.

Xavier University of Louisiana

College of Pharmacy · Division of Clinical and Administrative Sciences, New Orleans. All studies reviewed and approved by the Xavier University of Louisiana Institutional Review Board.

FQHC-partnered Gulf South focus IRB-approved Multilingual reach
Are Providers PrEPed? A Retrospective Cohort Study Analyzing Retention in Care among PrEP Patients
Clin HIV AIDS J · 2019;2(2):111 · DOI 10.31021/chaj.20192111
Pharmacist readiness & willingness to prescribe PrEP in the Gulf South
Two manuscripts in preparation / under review · 2025–26

Partner with us

Help bring PrEP to the Gulf South's front door.

We're looking for partners — foundations, health systems, industry, and community organizations — to build out the training and implementation phase with us, turning a willing, already-authorized pharmacist workforce into a functioning prevention network. Study data, protocols, and materials are available to prospective partners on request.

Sara Al-Dahir, PharmD, PhD · saaldah@xula.edu · (504) 520-5766