Advancing HIV Testing, Prevention, and Care Through Pharmacists and Pharmacies

Presenter:

Michael Stirratt, Ph.D.
Division of AIDS Research

Goal:

This concept aims to encourage research designed to further capacitate and scale the routine delivery of HIV testing, prevention, and care services through pharmacists and pharmacy settings, and support the advancement of training curricula that could enable pharmacy students, pharmacists, and pharmacies to effectively deliver HIV services with ease and equity.

Rationale:

Pharmacists and pharmacies have demonstrated exceptional reach and impact in the delivery of COVID-19 and influenza vaccines in recent years, and they may be well positioned to support further improvements in access to HIV testing, prevention, and care services. Pharmacies offer convenient evening and weekend hours, as well as co-location within neighborhoods and communities, and they are generally viewed as non-stigmatizing locations to access health care. Many U.S. retail pharmacy chains have also expanded their onsite clinical services. There is an opportunity to leverage these characteristics to improve pharmacy workforce capacities in HIV service delivery and meet the objectives of the U.S. National HIV/AIDS Strategy for 2022-2025 , which states that "pharmacists' knowledge and accessibility in nearly every urban and rural community can be leveraged as part of a comprehensive HIV prevention and care strategy to expand access to care and improve population health."

Pharmacy-based programs have facilitated access to HIV testing and prevention programs in populations that may not otherwise access these services. New models of pharmacy-based initiation and delivery of HIV pre-exposure prophylaxis (PrEP) have been pioneered in both domestic and global settings. Support for medication adherence represents a longstanding specialty of pharmacists, and pharmacy-centered programs that monitor antiretroviral prescription refills could provide an indicator of ongoing HIV care engagement, as well as a catalyst for timely intervention when there are gaps in prescription refills.

Models for successful pharmacy-based delivery of HIV testing, prevention, and care are ripe for further research and multisectoral collaboration. Central challenges in pharmacy settings include creating effective strategies to engage populations placed at risk for HIV or living with HIV; developing pharmacist training and skill improvement programs to support client interactions; ensuring care linkage and collaboration by forming Collaborative Practice Agreements with local physicians where indicated; and consideration of reimbursement strategies and financing models.

Research topics may include, but would not be limited to implementation science to further the planning, adoption, scale, and reach of: pharmacy-based health screenings for HIV alongside screenings for multiple chronic illnesses and common comorbid conditions including mental illnesses; pharmacy-based HIV PrEP delivery, including new long-acting injectable PrEP formulations; pharmacy-based monitoring and support for antiretroviral treatment adherence; and programs that train pharmacists, pharmacy students, and pharmacy technicians to support HIV prevention and care.