Pharmacy Students Report Stronger HIV and PrEP Training Than Medical Peers, Survey Finds

A new cross-sectional study of future health professionals in New York State suggests that the classroom pipeline feeding the next generation of HIV prevention providers may be leakier than public health goals demand. Researchers surveyed 385 medical and pharmacy students between November 2022 and January 2023, asking them how much education about HIV and about pre-exposure prophylaxis, or PrEP, they believed they had received during their academic training. The results, published in BMC Medical Education, reveal a striking pattern: while most students recalled some discussion of HIV risk, a substantial minority reported little or no exposure to PrEP content at all, and the depth of training varied dramatically depending on the student’s professional track, year of study, and gender.

The headline numbers frame the problem clearly. Overall, 71.95 percent of participants reported that HIV risk had been discussed during their training, and 64.42 percent said the same about PrEP. On the surface, those figures might seem encouraging, given that PrEP is a relatively recent addition to the prevention toolkit compared with decades of HIV education. But the study’s authors argue that the roughly one in three students who reported no PrEP discussion represents a missed opportunity at scale, because these are precisely the clinicians and pharmacists who will soon be prescribing, dispensing, and counseling patients about the medication that can reduce the risk of acquiring HIV through sex by about 99 percent when taken as directed.

The most eye-catching contrast in the data emerged between the two professional programs. After adjusting for other variables in multivariable ordinal regression models, pharmacy students had roughly twice the odds of medical students of reporting greater perceived HIV education, with an adjusted odds ratio of 2.03 and a 95 percent confidence interval of 1.35 to 3.04. The gap widened further for PrEP: pharmacy students had 3.41 times the odds of their medical counterparts of reporting greater perceived PrEP education, with a confidence interval of 2.23 to 5.22. That pharmacy trainees outpace medical trainees on PrEP awareness is notable, because physicians are often the ones expected to initiate PrEP prescriptions, while pharmacists increasingly serve as accessible touchpoints for medication counseling and, in many jurisdictions, direct pharmacy-based PrEP access.

The researchers also found that perceived education climbed steeply with academic seniority. Compared with first-year students, second-year students had nearly five times the odds of reporting greater perceived HIV education, with an adjusted odds ratio of 4.97, and more than five times the odds for PrEP education, at 5.42. Third-year students showed the strongest HIV signal in the entire analysis, with an adjusted odds ratio of 10.23, and fourth-year and beyond students reported the highest perceived PrEP education of all, with an adjusted odds ratio of 10.87. The trajectory makes intuitive sense: clinical content typically intensifies as students move from foundational coursework into rotations and experiential training. Yet the authors note that the pattern also implies first-year students, a group that includes many trainees who may already be interacting with peers and communities at risk, are largely entering professional school without meaningful PrEP literacy.

One of the more unexpected findings concerned gender. Cisgender women had lower odds than cisgender men of reporting greater perceived HIV education, with an adjusted odds ratio of 0.62, and lower odds of reporting greater perceived PrEP education, with an adjusted odds ratio of 0.51. In other words, even after accounting for program type and year of study, women in these cohorts consistently perceived less HIV and PrEP content in their training. The study did not test explanations for this disparity, but the finding raises questions about whether curricula, case materials, or classroom dynamics differ in ways that shape how students absorb and recall prevention content, and it flags a potential equity issue within the training environment itself.

Methodologically, the study relied on a cross-sectional survey design, which captures a snapshot of perceptions at a single point in time rather than tracking students longitudinally. The outcome measure was perceived education, meaning students’ own recollection and assessment of how much HIV and PrEP content they had encountered, not an objective audit of curriculum hours or a test of knowledge. Perception-based measures are valuable because they reflect what students feel prepared to act on, which influences whether future clinicians will raise prevention topics with patients. At the same time, the authors acknowledge that perception may not perfectly mirror actual curricular content, and the single-state sample of 385 students limits generalizability to other regions or professional programs.

The statistical approach deserves attention for readers who follow epidemiological methods. The team first used bivariate analyses to examine group differences in perceived education, then built multivariable ordinal regression models to estimate adjusted odds ratios with 95 percent confidence intervals. Ordinal regression is appropriate here because the perceived education outcome is ordered rather than binary, allowing the models to estimate how each predictor shifts a student’s position along a graded scale of reported educational exposure. The confidence intervals reported throughout the results exclude the null value of one, indicating that the associations between program type, academic year, gender, and perceived education were statistically reliable in this sample.

Why does this matter for public health? PrEP has been available in the United States since 2012, and federal initiatives have set ambitious targets for expanding its uptake, particularly among communities most likely to benefit, including gay and bisexual men, Black and Latino communities, people who inject drugs, and individuals in the American South and other high-burden regions. Yet uptake has lagged far behind eligibility, and a frequently cited barrier is that potential prescribers themselves feel unprepared to discuss or initiate PrEP. Studies like this one point to the upstream end of that pipeline: if a third of medical and pharmacy students report never discussing PrEP during training, the shortfall in confident prescribers and counselors is being manufactured years before those graduates see their first patients.

The pharmacy finding cuts both ways. On one hand, it suggests pharmacy curricula have integrated HIV prevention content relatively well, perhaps reflecting the profession’s central role in medication management and the growth of pharmacist-delivered preventive services. On the other hand, it highlights an asymmetry in which the professionals most likely to write initial PrEP prescriptions report less preparation than those most likely to fill and monitor them. Expanding pharmacy-based PrEP access, which several states now permit, could partially compensate, but the study’s authors argue that medical education also needs strengthening so that the two professions can function as a coordinated prevention workforce rather than an unevenly trained one.

The research team, led by Jacob Bleasdale and Emily Carter of the University of Central Florida, with colleagues at the University at Buffalo including Amy Hequembourg, Gene D. Morse, and Sarahmona Przybyla, framed their conclusions as an invitation to curriculum designers rather than an indictment of any single program. Their stated goal is to address the variability in educational experiences they documented and to better prepare future health professionals to care for the communities most likely to benefit from PrEP. The work was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health, with additional support to the lead author from the National Institute on Alcohol Abuse and Alcoholism. As PrEP formulations expand from daily oral tablets to longer-acting injectables, the educational demands on trainees will only grow, making the gaps identified here a moving target that curricula will need to chase deliberately rather than assume will close on its own.

Subject of Research: Perceived HIV and PrEP education among medical and pharmacy students

Article Title: Perceived HIV and PrEP education among medical and pharmacy students: a cross-sectional study

Article References: Bleasdale, J., Carter, E., Hequembourg, A., Morse, G. D., & Przybyla, S. (2026). Perceived HIV and PrEP education among medical and pharmacy students: a cross-sectional study. BMC Medical Education. https://doi.org/10.1186/s12909-026-10526-x

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10526-x

Keywords: HIV prevention, PrEP, medical education, pharmacy students, medical students, cross-sectional study, health professions education, pre-exposure prophylaxis, curriculum, New York State, ordinal regression, health communication