Addressing Barriers to HIV Point-of-Care Testing in Community Pharmacies

McKeirnan, Kimberly C.; Kherghehpoush, Sorosh; Gladchuk, Angie; Patterson, Shannon

doi:10.3390/pharmacy9020084

Cited by 10 publications

(7 citation statements)

References 17 publications

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“…Steps should be taken to address barriers around HIV testing in primary care to improve HIV detection rates [33,34]. In addition, pharmacies can provide point-of-care HIV testing [35] and participate in HIV prevention related to preexposure prophylaxis and post-exposure prophylaxis [36].…”

Section: Discussionmentioning

confidence: 99%

HIV Testing Uptake According to Opt-In, Opt-Out or Risk-Based Testing Approaches: a Systematic Review and Meta-Analysis

Soh

Chow

et al. 2022

Curr HIV/AIDS Rep

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Purpose of Review Improving HIV testing uptake is essential to ending the HIV pandemic. HIV testing approaches can be opt-in, opt-out or risk-based. This systematic review examines and compares the uptake of HIV testing in opt-in, opt-out and risk-based testing approaches. Recent Findings There remain missed opportunities for HIV testing in a variety of settings using different approaches: opt-in (a person actively accepts to be tested for HIV), opt-out (a person is informed that HIV testing is routine/standard of care, and they actively decline if they do not wish to be tested for HIV) or risk-based (using risk-based screening tools to focus testing on certain individuals or sub-populations at greater risk of HIV). It is not clear how the approach could impact HIV test uptake when adjusted for other factors (e.g. rapid testing, country-income level, test setting and population tested). Summary We searched four databases for studies reporting on HIV test uptake. In total, 18,238 records were screened, and 150 studies were included in the review. Most studies described an opt-in approach (87 estimates), followed by opt-out (76) and risk-based (19). Opt-out testing was associated with 64.3% test uptake (I2 = 99.9%), opt-in testing with 59.8% (I2 = 99.9%) and risk-based testing with 54.4% (I2 = 99.9%). When adjusted for settings that offered rapid testing, country income level, setting and population tested, opt-out testing had a significantly higher uptake (+ 12% (95% confidence intervals: 3–21), p = 0.007) than opt-in testing. We also found that emergency department patients and hospital outpatients had significantly lower HIV test uptake than other populations.

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Section: Discussionmentioning

confidence: 99%

HIV Testing Uptake According to Opt-In, Opt-Out or Risk-Based Testing Approaches: a Systematic Review and Meta-Analysis

Soh

Chow

et al. 2022

Curr HIV/AIDS Rep

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show abstract

Section: Discussionmentioning

confidence: 99%

“…(32) Steps should be taken to address barriers around HIV testing in primary care to improve HIV detection rates. (33,34) In addition, pharmacies can provide point-of-care HIV testing (35) and participate in HIV prevention related to pre-exposure prophylaxis and post-exposure prophylaxis. (36) One unexpected finding from our review was in settings where rapid testing was available, there was no significant difference in HIV test uptake compared to settings without rapid testing.…”

Section: Discussionmentioning

confidence: 99%

HIV testing uptake according to opt-in, opt-out or risk-based testing approaches: a systematic review and meta-analysis

Soh

Chow

et al. 2022

Preprint

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Purpose of review Improving HIV testing uptake is essential to ending the HIV pandemic. HIV testing approaches can be opt-in, opt-out or risk-based. This systematic review examines and compares the uptake of HIV testing in opt-in, opt-out and risk-based testing approaches. Recent findings There remains missed opportunities for HIV testing in a variety of settings using different approaches: opt-in (a person actively accepts to be tested for HIV), opt-out (a person is informed that HIV testing is routine/standard of care, and they actively decline if they do not wish to be tested for HIV) or risk-based (using risk-based screening tools to focus testing on certain individuals or sub-populations at greater risk of HIV). It is not clear how the approach could impact HIV test uptake when adjusted for other factors (e.g. rapid testing, country-income level, test setting and population tested). Summary We searched four databases for studies reporting on HIV test uptake. In total, 18,238 records were screened, and 150 studies were included in the review. Most studies described an opt-in approach (87 estimates), followed by opt-out (76) and risk-based (19). Opt-out testing was associated with 64.3% test uptake (I2=99.9%), opt-in testing with 59.8% (I2=99.9%), and risk-based testing with 54.4% (I2=99.9%). When adjusted for settings that offered rapid testing, country income level, setting and population tested, opt-out testing had a significantly higher uptake (+12% (95% confidence intervals: 3-21), p=0.007) than opt-in testing. We also found that emergency department patients and hospital outpatients had significantly lower HIV test uptake than other populations.

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“…Professionals do not have information about the user’s confirmatory test or adherence to treatment, which is identified by some authors as a limitation and one of the aspects to change in the future [ 20 , 21 ]. Another barrier identified was logistics regarding the resources, permanent availability of trained professionals, and managing the time to perform the tests within the pharmacy workflow [ 41 ]. Other studies also mention fear of becoming infected and costs for the tests as barriers [ 18 , 41 ].…”

Section: Discussionmentioning

confidence: 99%

“…Another barrier identified was logistics regarding the resources, permanent availability of trained professionals, and managing the time to perform the tests within the pharmacy workflow [ 41 ]. Other studies also mention fear of becoming infected and costs for the tests as barriers [ 18 , 41 ]. Additionally, there exists a latent and niche group of consumers interested in POC tests in community pharmacies who are younger and in general willing to pay more than the general population for this service [ 42 ].…”

Section: Discussionmentioning

confidence: 99%

Point-of-care HIV and hepatitis screening in community pharmacies: a quantitative and qualitative study

Figueira¹,

Teixeira²,

Rodrigues

et al. 2022

Int J Clin Pharm

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Background Point-of-care tests can contribute to earlier diagnosis and treatment of infectious diseases, thereby affording the opportunity to prevent chronic stages and the spread to others. As part of the Fast-Track Cities initiative, a pilot study was initiated in community pharmacies in Portugal. Aim To characterize the individuals choosing to have point-of-care testing or screening for human immunodeficiency virus, hepatitis C, and hepatitis B virus infections in community pharmacies, their risk behaviours and motivations to perform the tests, as well as to understand the facilitators and barriers from the perspective of pharmacists. Method A quantitative and qualitative study was conducted. A survey was applied to test users in pharmacies between May and December 2019, and three focus groups were conducted with six, four, and five pharmacists involved in the initiative. Qualitative data were analysed according to thematic content analysis. Results A total of 210 questionnaires were collected (57.9% response rate). Point-of-care test users were predominantly male, mean age of 35 (± 13.0) years, the majority had higher education level, and 22.8% were born outside of Portugal. Almost half of the users were first time tested and the main reason for screening was unprotected sexual intercourse. Pharmacists identified speed, confidentiality, counselling provided to users, pharmacists’ initial training to perform the tests, and trust in the pharmacist as facilitators of these tests. Stigma associated with infections, the procedure, logistical conditions, and the referral process were considered as barriers. Conclusion Pharmacies are a screening site with special importance for individuals who are first tested, heterosexuals, and some migrants. Nevertheless, it is necessary to understand and reduce barriers and increase the support to specific groups. Supplementary Information The online version contains supplementary material available at 10.1007/s11096-022-01444-1.

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Addressing Barriers to HIV Point-of-Care Testing in Community Pharmacies

Cited by 10 publications

References 17 publications

HIV Testing Uptake According to Opt-In, Opt-Out or Risk-Based Testing Approaches: a Systematic Review and Meta-Analysis

HIV Testing Uptake According to Opt-In, Opt-Out or Risk-Based Testing Approaches: a Systematic Review and Meta-Analysis

HIV testing uptake according to opt-in, opt-out or risk-based testing approaches: a systematic review and meta-analysis

Point-of-care HIV and hepatitis screening in community pharmacies: a quantitative and qualitative study

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