Q&A: Why Pharmacy Is Incentivized to Eliminate HIV Stigma

The collective understanding of HIV has developed significantly throughout the past 25 years and prior, leading to innovative new treatment and prevention options for patients. However, developments in this space have also led to the stigmatization of HIV and the common populations that experience it, which has led community pharmacists to step in and dispel misinformation.

“When we think about incentives, yes, [HIV care and prevention is] a public health need, but I would also venture to say it is a profitability consideration too,” Kenric B. Ware, PharmD, MBA, AAHIVP, clinical associate professor of pharmacy practice at Mercer University, told Drug Topics. “I mean, pharmacies are businesses. If you're reaching more people and you're providing more services to people, then invariably they would do more business with you and recommend other people to do business with you as well.”

In part 2 of our interview with Ware, he focused on the pharmacists dispensing PrEP, PEP, and other medical services related to HIV care and prevention. From the medications they’re quite familiar with to the unique public health positioning pharmacists possess, Ware went into depth about the evolving role of pharmacists in providing HIV care and improving patient outcomes.

READ MORE: FDA Approves First 1-Minute Self Test for HIV

Drug Topics: What role do pharmacists play either in addressing stigma or providing HIV care services? More specifically, what skills or expertise do pharmacists have that set them apart compared with other providers in the HIV space?

Kenric B. Ware:  I think pharmacists are commonly privy to medications that people take for sexually transmitted infections (STIs) in the pharmacy setting, or even requests for over-the-counter products like Plan B, or the morning after pill, or the emergency pill. [These interactions] really could be used as PrEP prompts, prompting people to have conversations around pre-exposure prophylaxis, obviously in a respectful and an affirming manner. You recognize every pharmacy is set up a little bit differently, so you want to have an eye toward privacy and all of those things. But I think [it’s] leveraging the therapies that people are taking to be able to have those conversations.

Now each pharmacist is going to approach that differently. That clearly requires a level of rapport with people beforehand because people may not be too excited about unwelcome conversations around HIV prevention based upon what they're taking. There definitely requires a preexisting relationship, one that's a bit more healthy. But I think using those medications would really be helpful.

As many people may know, there are several states that pharmacists are actually prescribing PrEP and PEP, or post-exposure prophylaxis. In essence, PEP is after the fact; after they're suspected or [have] known exposure to HIV within 72 hours and for about a month, or 28 days, people would take this PEP. Pharmacists are initiating those therapies in a lot of spaces, so that kind of helps us as well.

To what you asked about what sets pharmacists apart, I think definitely having that knowledge of drug interactions, things that are OTC that people are using that may complicate the therapies that people are taking. That may require some modifications, some dose adjustments based upon what they're already taking. Additionally, pharmacists are really skilled at navigating drug assistance programs to make sure that patients not only get the medications but it's affordable. I think those are some things that really put pharmacists in kind of a unique position.

Drug Topics: Why may a pharmacy be incentivized to address these stigmas and begin providing HIV prevention and care services?

Kenric B. Ware:  I think one of the big incentives is that we're probably all familiar with the fact that pharmacies are really accessible, probably more than clinics and hospitals in a lot of areas—particularly some of our rural areas. Pharmacies rebrand themselves to a certain extent into these public health portals, where people not only get HIV prevention but other chronic maintenance considerations as well. I think the incentive there is to really recognize that pharmacies compete among themselves in different spaces and areas. [It's important to] kind of have that public health-facing approach that we want to be a place where our pharmacists, our pharmacy personnel, are equipped and mindful of public health considerations.

Also, they're incentivized to address some of these stigmas by even participating in telehealth. A lot of pharmacies have really taken that plunge to go into telehealth, which really increases their reach, obviously their footprints into a lot of underserved areas, and in turn, it really does create a more loyal customer base. People will maybe come and get some of their longstanding needs, like immunizations and other considerations. When we think about incentives, yes, it's a public health need, but I would also venture to say it is a profitability consideration too. I mean, pharmacies are businesses. If you're reaching more people and you're providing more services to people, then invariably they would do more business with you and recommend other people to do business with you as well.

READ MORE: HIV Resource Center

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