Findings from a School of Pharmacy research study indicate that a pharmacy-based HIV screening program is acceptable, feasible and effective in reaching a vulnerable segment of the population.
The individuals of this population may be at risk for HIV and/or have never been tested.
Drs. Debbie Kelly and Jason Kielly, co-principal investigators, and their team of researchers received a grant from the Canadian Institutes of Health Research’s HIV Implementation Science (Component 1) to complete the study, which launched on Valentine’s Day this year.
The APPROACH study offered free HIV testing in select Newfoundland and Labrador and Alberta pharmacies for a six-month period.
The goal was to develop a pharmacy-based testing model for HIV, to learn how to deliver the service effectively and to determine clients’ level of comfort of being tested for HIV at a pharmacy.
Overcoming barriers, improving accessibility
HIV testing in Newfoundland and Labrador is currently available through family doctors, sexual health clinics or in hospitals.
For those living outside the St. John’s area or without a family doctor, obtaining an HIV test is more challenging. Besides access, other barriers include privacy concerns and the perceived stigma of asking about or making an appointment to receive a test.
“Getting tested is more important than ever, because people who have HIV can live long and healthy lives as long as they know they’ve been infected and they are linked to care,” said Dr. Kelly.
One in five people living with HIV in Canada do not know their status. The challenge, then, is to improve the rate of diagnosis so individuals can receive the treatment and therapy they need.
“The APPROACH study demonstrated that a novel HIV testing program offered by pharmacists can overcome many of the barriers that exist and can increase access to HIV testing in both Newfoundland and Labrador and Alberta,” Dr. Kelly said.
Methodology, results and the way forward
During the study period, participating pharmacies offered a “rapid” point-of-care HIV test.
This involved a finger prick blood sample to detect HIV antibodies, with results delivered in just one minute.
Pharmacists also counselled clients about how HIV is transmitted, ways to protect themselves in the future and advised where in their community they could get tested for other sexually transmitted and blood-borne infections (STBBI).
During the six-months, 123 tests were performed and, of these, one new case of HIV was identified.
The individual was supported by the pharmacist and successfully linked with care through the provincial HIV program.
“It is noteworthy that 99.2 per cent of the clients feel that HIV testing should be offered through pharmacies routinely.”
Dr. Kielly believes HIV testing should be available through select pharmacies permanently.
“The survey results revealed that clients were comfortable being tested in a pharmacy, confident in the pharmacist’s ability to do a good job and reported that they would likely also get tested for other STBBIs in a pharmacy,” he said.
“It is noteworthy that 99.2 per cent of the clients feel that HIV testing should be offered through pharmacies routinely.”
Looking forward
Next on the agenda?
Expand the testing program into additional sites within Newfoundland and Labrador and Alberta, as well as in other provinces.
“We also want to include testing for hepatitis C and syphilis,” said Dr. Kielly, who is leading a team of researchers in Newfoundland and Labrador, Alberta, Nova Scotia and Saskatchewan in the next phase of the project.
The team has submitted a $1.5-million grant proposal to the Canadian Institutes of Health Research in order to fund the five-year study. Results of the grant application are expected in January.
“The committee’s work over the next five years aims to get to zero new infection, zero deaths, zero stigma.”
The APPROACH study aligns with the work of the AIDS Committee of Newfoundland and Labrador’s (ACNL) work to increase awareness of the importance of being tested for HIV, especially outside the metropolitan St. John’s area.
“This will have a great impact on the health system’s ability to provide access, especially in rural areas,” said Gerard Yetman, executive director, ACNL.
“The committee’s work over the next five years aims to get to zero new infection, zero deaths, zero stigma. This can only be achieved if we can provide better access to testing in this province.”
A news conference announcing the APPROACH study’s findings will take place on Friday, Dec. 1, World AIDS Day, at 10 a.m. at the AIDS Committee of Newfoundland and Labrador’s offices at 47 Janeway Pl. in St. John’s.
