Readiness and factors influencing community participation in the HIV-Focused Community Retail Pharmacy Drug Distribution Point (CRPDDP) Program in Kampala City, Uganda

Abstract

Background: Globally, HIV remains a persistent public health concern. As of 2022, approximately 39 million people were living with HIV (PLHIV), with adults accounting for over 95% of this population (UNAIDS, 2023). ART coverage globally reached 76% in 2022, still falling short of the UNAIDS 95-95-95 targets aimed at ending the AIDS epidemic by 2030 (WHO, 2023).This study assessed the proportion of readiness, identified factors favoring and barriers to participation of community retail pharmacies (CRPs) in the Community Retail Pharmacy Drug Distribution Point (CRPDDP) program for HIV service delivery in Kampala City, Uganda. Methodology: A cross-sectional design was employed, involving 304 pharmacies across the city’s five administrative divisions. Quantitative data gathered from the surveys were summarized and Cleaned-in Ms. Excel then analyzed using SPSS version 26. Results: Findings revealed a critical participation gap: only 3.9% of CRPs were actively enrolled in the CRPDDP program, yet out of the 292 non-participating pharmacies assessed, 76.7% met or exceeded the 75% readiness threshold based on 20 facility-level indicators. Most pharmacies complied with regulatory and structural domains such as licensure, pest-free storage, and temperature monitoring. However, notable gaps were identified in HIV-specific service areas, with only 11.2% of CRPs having ART counseling spaces, 7.8% maintaining adverse drug reaction records, and 20.1% equipped with dedicated ART dispensing points. Most community retail pharmacies complied with the presence of a supervising pharmacist, dedicated infrastructure, and prior involvement in public health programs. Barriers to enrollment were primarily perceptual and systemic, including low program awareness and stigma concerns. Conclusion: The study concludes that while Kampala’s CRPs demonstrate substantial technical capacity, their integration into the national HIV response remains limited. Bridging this readinessparticipation divide will require targeted HIV training, mentorship, simplified policy communication, infrastructure support, and performance-based incentives to fully harness the potential of CRPs in differentiated ART service delivery.