Study Aim: To evaluate the feasibility and acceptability of pharmacy-based sexual and reproductive health (SRH) and HIV prevention services for young women in Zanzibar, including female sex workers (FSW), students, and other young women.
Background:
Young women in Zanzibar face significant barriers to accessing HIV prevention and family planning services, including stigma, privacy concerns, misinformation, and limited youth-friendly care. Although free SRH services are available, many young women remain underserved. Pharmacies may provide an important alternative platform for delivering youth-friendly SRH and HIV prevention services because they are accessible, discreet, community-based, and already widely used for contraception and other health products.
This study examined whether elements of the “Malkia Klabu” pharmacy-based service model from mainland Tanzania could be adapted for Zanzibar to improve access to HIV prevention and SRH services for young women. The project used a mixed-methods approach in Unguja and Pemba, including quantitative surveys, discrete choice experiments (DCEs), focus group discussions, in-depth interviews, and pharmacy observations. Participants included female sex workers, students, other young women, pharmacy owners and staff, and key stakeholders from government, schools, NGOs, and youth-friendly service organizations.
Project Summary:
The project assessed young women’s HIV prevention and family planning knowledge, healthcare experiences, perceptions of pharmacies, HIV testing behaviors, contraception use, and awareness and uptake of PrEP, PEP, and HIV self-testing. Discrete choice experiments were conducted to evaluate preferences for HIV prevention products and pharmacy-based service delivery models. Focus group discussions and interviews explored barriers to care, privacy concerns, stigma, and recommendations for youth-friendly pharmacy services.
The study also evaluated pharmacy readiness to provide integrated SRH and HIV prevention services, including infrastructure, staffing, product availability, provider attitudes, confidentiality practices, and willingness to offer youth-friendly services. Pharmacy owners and staff were interviewed regarding the acceptability of free SRH products, counseling services, incentives, HIV prevention technologies, and implementation considerations for future pharmacy-based programs.
In addition, the project engaged key stakeholders to identify policy, regulatory, cultural, and operational considerations for implementing pharmacy-based SRH and HIV prevention services in Zanzibar.
Conclusions:
Findings supported the feasibility and acceptability of pharmacy-based SRH and HIV prevention services for young women in Zanzibar. Results highlighted the importance of privacy, non-judgmental counseling, youth-friendly pharmacy staff training, tailored outreach approaches, and clear referral systems. The study generated evidence to guide future adaptation and implementation of integrated pharmacy-based HIV prevention and reproductive health interventions for young women in Zanzibar.