Assessing community pharmacists’ involvement and clients’ opinion on HIV/AIDS services in community pharmacies in Nigeria: a cross-sectional survey

Abstract

The World Health Organization is promoting community-based services to end HIV/AIDS by 2030. In Nigeria, studies on community pharmacists’ involvement in HIV testing services (HTS) and antiretroviral (ARV) medication therapy management (MTM) are scarce, and no study had evaluated the clients’ opinion on community pharmacy HTS. We assessed the community pharmacists’ involvement in HIV/AIDS services and clients’ opinions of community pharmacy HTS. Semi-structured questionnaires on a five-point Likert scale were administered to 701 selected community pharmacists and 5840 clients in southwest Nigeria in 2019. Data were analyzed with descriptive and inferential statistics. Response rates were 68.6% and 69.8% for community pharmacists and clients, respectively. Only 18.5% of community pharmacists offered rapid HTS and 30% refills of ARV. The total score of their involvement on the HTS was 20.94 ± 17.521 (range 8–40; midpoint 24) and on ARV/MTM was 22.98 ± 19.61 (range 9–45; midpoint 27), while 91% were willing to participate in training. Barriers to integrating services into practice were lack of clinical tools (46.8%), lack of collaboration with other healthcare professionals (39.1%), and lack of training on HIV/AIDS services (36.2%) among others. Also, 77% of the clients were willing to participate in community pharmacy HTS, and about 83% of them responded that knowing their HIV status will help them to take necessary precautionary actions. Community pharmacists’ involvement in HIV/AIDS services was low. However, they showed willingness to participate in training to improve services. Also, clients were willing to receive community pharmacies HTS to know their status.

The effectiveness, feasibility and acceptability of HIV service delivery at private pharmacies in sub‐Saharan Africa: a scoping review

“…One effectiveness study, a randomized trial, explored the effect of HIV self‐testing (HIVST) vouchers redeemable at varying prices and distribution sites, including private pharmacies in urban areas, on service uptake [ 41 ]. Four studies explored the feasibility of [ 19 , 42 , 43 , 44 ] and two studies explored the acceptability of [ 45 , 46 ] of this HIV testing service delivery model. The studies measured all effectiveness and feasibility outcomes post‐implementation and acceptability outcomes pre‐implementation.…”

“…A pilot study in South Africa that found pharmacy‐delivered HIVST feasible also found that many clients who tested HIV positive already knew their HIV status [ 42 ]. The studies assessing acceptability, both qualitative, found that Ugandan men anticipated higher uptake of HIVST at a pharmacy versus other community delivery models [ 45 ] and that Nigerian pharmacy clients and providers were generally willing to engage in pharmacy‐delivered HIV testing services [ 46 ].…”

“…In the studies that measured acceptability outcomes, our review suggests that while pharmacy‐delivered HIV services are perceived to be largely acceptable, this may be conditional on pharmacy providers’ ability to maintain clients’ privacy [ 46 , 57 , 63 , 65 , 66 ] and provide high‐quality services [ 53 , 55 , 63 , 67 ]. As such, implementers should consider interventions that might increase the privacy of pharmacy‐delivered HIV services, such as integrating self‐screening tools for HIV risk [ 74 , 75 ], delivering antiretroviral drugs in discrete packaging [ 76 , 77 ] and counselling clients in a private setting [ 62 ].…”

“…Additionally, in the studies that measured feasibility outcomes, client HIV service uptake and continuation at private pharmacies was comparable to, or higher than, that at public clinics [41, 46–49, 51, 52, 55, 72]. This could be attributable to the increased convenience and efficiency of pharmacy‐delivered services; private pharmacies are more prevalent in many sub‐Saharan African settings, especially in urban areas, and generally deliver faster services than public clinics [65].…”

“…Four studies explored the feasibility of [19,[42][43][44] and two studies explored the acceptability of [45,46] of this HIV testing service delivery model. The studies measured all effectiveness and feasibility outcomes post-implementation and acceptability outcomes pre-implementation.…”