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

Abstract

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.

Estimated cost-effectiveness of point-of-care testing in community pharmacies vs. self-testing and standard laboratory testing for HIV

“…Several studies have provided evidence confirming strong capability and willingness of pharmacists to provide HIV test (and associated counseling) [10,12,41]. Pharmacists who offer HIV testing receive training in the practical administration of the test as well as in counseling and linkage to care, which support their confidence and willingness to provide HIV testing and counseling [10,12,42].…”

“…A recent study reported that 99% of patients agreed HIV POCT should be routinely offered in pharmacies and 78% were willing to pay for the service [10]. They also said that getting POCT testing at a pharmacy was convenient and discreet, and that the pharmacist was supportive and provided effective education about how to reduce their future risk [10,41,43].…”

Sexual health challenges in migrant, immigrant, and displaced populations 2022–2023

“…Screening availability at multiple service types appears to facilitate access. Pharmacy-based HIV, HBV/HCV screening in Portugal was shown to be effective for MIDP as speed, confidentiality, and trust in pharmacists were strong [72]. Streamlining testing logistics and reducing delays in linkage-to-care are key: a Montreal-based intervention demonstrated that free, rapid antiretroviral therapy initiation allowed MIDP living with HIV to take control of their health and encouraged sustained HIV care engagement [73].…”

HIV-HCV Incidence in Low-Wage Agricultural Migrant Workers Living in Ghettos in Apulia Region, Italy: A Multicenter Cross Sectional Study

“…In our survey, only 89 migrants (29%) reported having a family doctor and thus primary access to care. According to the 2017 WHO Global Hepatitis Report, only 20% of HCV infected people are aware of their infection globally [ 20 ]. With regard to HIV, the Joint United Nations Programme on HIV/AIDS (UNAIDS)reports that 85% of all people living with HIV knew their status in 2021.…”