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Background: Knowledge and competence of community pharmacists in HIV care, are essential for translating the goals of differentiated care into improved outcomes. Aims: To assess the knowledge and competence of community pharmacists in Jos, for differentiated HIV care and services. Study Design: Cross-sectional questionnaire survey. Place and Duration of Study: Community pharmacies in Jos North and Jos South local government areas of Plateau state, North-Central Nigeria, between September to November, 2018. Methodology: We included community pharmacists who responded to six items on knowledge of HIV therapeutics with each correct answer recording a score of 1 and zero for wrong answers. Respondents with a correct score of 5 or 6 represent good knowledge. We examined competence on a 36 item scale graded 1 for weak competence and 5 for strong competence. Factor analysis; reduce the 36 scale items down to competency domains. Frequencies and percentages for reported competencies were presented. In addition, aggregated scores for each of the competency domains were used to compare respondents based on years of experience, educational level and employment status in community pharmacy. All levels of significance were set at p≤ 0.05. Results: 73 out of 110 community pharmacists responded to the questionnaire. Of these, only 25% reported good level of knowledge in HIV therapeutics. 69% reported strong competency in identifying drug therapy problems, 31% inter-professional and patient communication. There was statistically significant difference in competency domains based on years of practice experience and employment status p<0.05. Respondents with 10 years or less of practice experience recorded higher mean ranked scores compared to those with 11 or more years. Similarly, employed pharmacists recorded higher mean ranked scores than those who owned their business. Conclusion: Overall, respondents reported low knowledge and weak competency in HIV care emphasizing the need for specialized training before implementation of differentiated care model.

HIV is a complex and multifaceted entity, especially in terms of the biopsychosocial model of disease. For decades, its biological characteristics have consistently outstripped our human ability to understand its molecular and pathogenic complexities. The psychosocial, legal and ethical implications are equally devastating, requiring concerted global debates and commitments on the subject of human rights. While the Universal Declaration of Human Rights (UDHR) was adopted as an instrument that guarantees and safeguards the inherent dignity and equality of every being, and as a framework for bettering the relationship between a government and its citizenry, the translation of the declaration into practical law, and its subsequent implementation, has suffered continual debates, hitches and neglect worldwide. [1] To what extent has Nigeria implemented policies protecting any of the 'rights' it purports to defend? It is evident that in Nigeria, HIV-positive people are denied employment and even access to healthcare on the basis of stigmatisation. [2] Mandatory HIV testing as a prerequisite for surgery, and even worse, the refusal of treatment to patients infected with the virus, is ethically unacceptable worldwide. [3] In India, such practice was criticised and said to have no public health justification, as it has the potential to drive vulnerable and possibly HIV-positive people out of HIV/AIDS intervention programmes. [4] Thomas [3] showed that even when the government had issued guidelines in compliance with the UDHR charter, they were rarely enforced, resulting in the widespread practice of mandatory HIV testing, with practitioners maintaining that the risk of transmission is not zero, despite universal precautions. While surgeons could argue the case on the basis of their risk of infection, mandatory testing leads to stigmatisation and discrimination. Conversely, in the developed world, many clients treat infected health practitioners with distrust, a situation that led the American College of Surgeons (ACS) to release a guideline to resolve the stalemate. [5] This study assessed the practice of mandatory HIV testing, HIV testing without consent and disclosure of test results in Nigeria.

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