Table 3.

Determinants of acceptability of pharmacy-based PrEP delivery, organized by components of the Consolidated Framework for Implementation Research

CFIR domain	CFIR construct: specific determinant		Illustrative quote
Intervention characteristics	Relative advantage:a Relative advantage	(A)	“If those who feel stigmatized queuing here [at the hospital] can pick it [PrEP] from somewhere else, it will decongest [public PrEP clinics].” (Kiambu PrEP Provider 3)
	Cost: Affordability	(B)	“[Whether I will get PrEP at a pharmacy] will depend on the cost. I may find that I have run out of drugs and I don’t have money. So that may be a challenge.” (Kiambu PrEP Client 10)
	Cost: Profitability	(C)	“This is a business also … so you can’t expect someone to handle [PrEP] clients unless they bring money.” (Kiambu Pharmacy Provider 4)
Inner setting	Available resources: Privacy	(D)	“[The HIV testing and PrEP counseling] must be done in a private room in the chemist … Clients want to feel relaxed and secure.” (Kiambu PrEP Client 14)
Characteristics of individuals	Knowledge and beliefs: Competency	(E)	“[Pharmacy PrEP could work] as long as whoever is mandated [to deliver PrEP at the pharmacy] is well-trained and they understand the importance of PrEP and what it does, what is going to happen if it is misused, the benefits, and all that.” (Kiambu PrEP Provider 4)
	Other personal attributes: Professionalism - Ethics	(F)	Ethics:“[Pharmacy PrEP acceptability] is all about the [ability of the] pharmacist at the chemist to keep clients’ confidentiality because PrEP has stigma.” (Kiambu PrEP Client 14)
	- Respect	(G)	Respect: “[Pharmacy PrEP providers] should not have a judgmental attitude… If you tell them you had unprotected sex recently … [they need to] be understanding.” (Kiambu Pharmacy Client 12)
	- Integrity	(H)	Integrity: “Here [at the hospital] I will follow the rules and say [to a client], ‘If you are not [HIV] tested, I will not issue the [PrEP] drugs.’ But in the pharmacy … they may be interested in the money over the testing.” (Kiambu PrEP Provider 9)
Outer setting	Patient needs and resources: Rapport	(I)	“[Pharmacy PrEP providers] should have good relationships with their clients … [The provider] there at the pharmacy [I go to], we are like friends. He knows my medical history.” (Kisumu Pharmacy Client 8)
		(J)	“[Some clients] will not feel comfortable … if [the pharmacy PrEP provider] knows them personally. So they will prefer to pick them [PrEP drugs] from another chemist.” (Kiambu Pharmacy Client 10)
	External policies and incentives: Quality regulations	(K)	“Clients should be protected … [and] assured that they will get good health services … Chemists that offer PrEP should meet some minimum standards to handle patients.” (Kiambu PrEP Client 14)

^aFor additional results on relative advantages, see Table 2