Pharmacists have the expertise and accessibility to help combat the spread of HIV.
The emergence of the human immunodeficiency virus (HIV) shook humanity to its core. A disease that was initially thought to exclusively impact a specific demographic quickly transformed into a global epidemic that shattered boundary lines across continents.
We have learned much about HIV throughout the decades. We know how the disease is transmitted, we know that it can infect anyone, and we know that approximately 1.2 million people in the United States have HIV today.
The Elton John Aids Foundation recently hosted a meeting to discuss its initiative, Expanding Access to HIV Prevention and Linkage to Care Services in Community Pharmacies. OmniSYS’ Chief Pharmacy Officer David Pope joined leaders from AIDS United, the American Pharmacists Association, Avita Care, the Frannie Peabody Center, NASTAD, and Courage Forward Strategies to examine the initiative and discuss the role pharmacies should play in fighting the HIV epidemic.
Challenge: Decreasing the Risk of HIV Infections
The most recent data shows more than 36,000 people received a new HIV diagnosis in the US in 2021. Although the number represents an overall decrease of 7% from 2017-2021, some demographics still face a notable gap in access to preventative care.
Pre-exposure prophylaxis (PrEP) is a medication that reduces the chances of contracting HIV through sex or injection drug use. According to information shared during the initiative, two groups significantly impacted by the virus do not have access to the drug. Only 13% of Black and 24% of Hispanic people in at-risk categories have a PrEP prescription, versus 94% of their White counterparts.
David Pope shared that expanding care in pharmacies could help close that gap.
“Black and Latino communities are often burdened by a lack of access to primary care in their respective neighborhoods,” Pope said. “Diversifying the healthcare settings and types of providers offering PrEP and PEP prescribing can potentially help these at-risk groups get their medications.”
The American South accounts for more than half of new HIV diagnosis, despite the fact that only 38% of the country’s population live in the region. The South is a hotbed for HIV transmissions due to a lack of clinicians who can prescribe PrEP.
“Pharmacists are more than capable of filling that need. They are highly trained healthcare professionals. It’s time we realize the full potential of their skillset,” Pope stated. “Community pharmacies offer significant accessibility to potential patients and create an excellent opportunity for them to receive initial PrEP and PEP treatment while removing typical barriers.”
Opportunity: Increase Access to HIV Prevention and Linkage to Care
Pharmacies are the most accessible healthcare facilities in America. There are over 60,000 pharmacies nationwide, and nearly 90% of the population lives within five miles of a pharmacy.
Pope is advocating that the pharmacy industry’s reach should be considered when we think about ways to disrupt the spread of HIV.
“Pharmacies are the cornerstones of healthcare accessibility and a vital resource for public health,” he said. “Pharmacies are not just drug dispensaries; they are healthcare hubs that can play a crucial role in combating HIV through education and access to PrEP and PEP.”
Solution: Push for Legislative Change
Utilizing pharmacies to combat the spread of HIV requires backing from both federal and state policies. The full potential of pharmacy-based HIV services needs regulatory support to be completely actualized.
One piece of the legislative pie is related to clinical authority. Today, 19 states have given prescriptive authority to pharmacists for PrEP and PEP.
“Just imagine if all 50 states were to give pharmacists prescriptive authority for PrEP and PEP,” Pope emphasized. “Then everyone within five miles of a pharmacy would have access to treatment.”
Pharmacists also need legislative support to receive the proper reimbursement for their services.
“Colorado and Oregon passed legislation that allows pharmacists to prescribe HIV-preventative drugs and get reimbursed for their services,” Pope said. “We must continue to advocate for pharmacists to operate at the top of their licenses if we want to see similar laws passed nationwide.”