The Role of Pharmacies in the HIV Prevention and Care Continuums: A Systematic Review

Crawford, Natalie D.; Myers, Sky; Young, Henry N.; Klepser, Donald G.; Tung, Elyse

doi:10.1007/s10461-020-03111-w

Cited by 30 publications

(28 citation statements)

References 48 publications

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“…Findings from this research are congruent with prior cohort studies suggesting that obtaining syringes from SEPs reduce syringe sharing behaviors [10,16,17,38]. This study supports findings from a smaller number of studies focusing on the protective association between obtaining syringes at pharmacies and syringe sharing behaviors [8,11],This study is the first study using nationally representative data of the U.S population to examine the protective associations between obtaining syringes at pharmacies and SEPs. This study underscores the need to scale up and expand the provision of sterile syringes in the United States, particularly in pharmacies which have traditionally been an underutilized resource in HIV prevention efforts [8].…”

Section: Discussionsupporting

confidence: 87%

“…This study supports findings from a smaller number of studies focusing on the protective association between obtaining syringes at pharmacies and syringe sharing behaviors [8,11],This study is the first study using nationally representative data of the U.S population to examine the protective associations between obtaining syringes at pharmacies and SEPs. This study underscores the need to scale up and expand the provision of sterile syringes in the United States, particularly in pharmacies which have traditionally been an underutilized resource in HIV prevention efforts [8]. The strong associations between cleaning and reusing syringes with bleach and engaging in syringe sharing further underscores the need to expand SEPs and pharmacy access to sterile syringes.…”

Section: Discussionsupporting

confidence: 85%

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Assessing the relationship between syringe exchange, pharmacy, and street sources of accessing syringes and injection drug use behavior in a pooled nationally representative sample of people who inject drugs in the United States from 2002 to 2019

et al. 2021

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Provision of sterile syringes is an evidence-based strategy of reducing syringe sharing and reusing and yet, access to sterile syringes through pharmacies and syringe exchange programs (SEPs) in the United States remains inadequate. This nationally representative study examined associations between obtaining syringes from pharmacies, SEPs, and sterilizing syringes with bleach and risk of syringe borrowing, lending and reusing syringes in a pooled cross-sectional dataset of 1737 PWID from the 2002–2019 National Survey on Drug Use and Health. Logistic regression was used to produce odds ratios (OR) of the odds of injection drug behaviors after adjusting for obtaining syringes from SEPs, pharmacies, the street, and other sources and potential confounders of race, ethnicity, sex, education, and insurance coverage. Obtaining syringes through SEPs was associated with lower odds of borrowing (OR = .4, CI95% = .2, .9, p = .022) and reusing syringes (OR = .3, CI95% = .2, .6, < .001) compared to obtaining syringes on the street. Obtaining syringes from pharmacies was associated with lower odds of borrowing (OR = .5, CI95% = .3, .9, p = .037) and lending (OR = .5 CI95% = .3, .9, p = .020) syringes. Using bleach to clean syringes was associated with increased odds of borrowing (OR = 2.0, CI95% = 1.3, 3.0, p = .002), lending (OR = 2.0, CI95% = 1.3, 3.0, p = .002) and reusing syringes (OR = 2.4, CI95% = 1.6, 3.6, p < .001). Our findings support provision of syringes through pharmacies and SEPs as a gold-standard strategy of reducing sharing and reuse of syringes in the US.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionsupporting

confidence: 85%

Assessing the relationship between syringe exchange, pharmacy, and street sources of accessing syringes and injection drug use behavior in a pooled nationally representative sample of people who inject drugs in the United States from 2002 to 2019

et al. 2021

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“…Pharmacies may be valuable sources of sterile syringes in rural areas hard hit by injection-related epidemics. In many rural areas globally, pharmacies are plentiful, and pharmacists are one of the most accessible frontline health care providers; they are well positioned to provide care and advice, especially for vulnerable populations in limited resource settings [ 14 , 21 , 43 ]. In the USA, data indicate that 89% of Americans live within five miles of a pharmacy [ 2 , 37 ].…”

Section: Introductionmentioning

confidence: 99%

A qualitative study on pharmacy policies toward over-the-counter syringe sales in a rural epicenter of US drug-related epidemics

et al. 2022

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Background Expanding access to sterile syringes in rural areas is vital, as injection-related epidemics expand beyond metropolitan areas globally. While pharmacies have potential to be an easily accessible source of sterile syringes, research in cities has identified moral, legal and ethical barriers that preclude over-the-counter (OTC) sales to people who inject drugs (PWID). The current study builds on prior urban-based research by elucidating (1) pharmacy OTC policies and (2) pharmacists’ rationale for, and barriers and facilitators to, OTC syringe sales in a US rural area hard hit by drug-related epidemics. Methods We conducted 14 semi-structured interviews with pharmacists recruited from two Eastern Kentucky health districts. Interview domains included experiences with, and attitudes toward, selling OTC syringes to PWID. Constructivist grounded theory methods were used to analyze verbatim transcripts. Results Most pharmacists operated “restrictive OTC” pharmacies (n = 8), where patients were required to have a prescription or proof of medical need to purchase a syringe. The remainder (n = 6) operated “open OTC” pharmacies, which allowed OTC syringe sales to most patients. Both groups believed their pharmacy policies protected their community and pharmacy from further drug-related harm, but diverging policies emerged because of stigma toward PWID, perceptions of Kentucky law, and belief OTC syringe sales were harmful rather than protective to the community. Conclusion Our results suggest that restrictive OTC pharmacy policies are rooted in stigmatizing views of PWID. Anti-stigma education about substance use disorder (SUD), human immunodeficiency virus (HIV), and Hepatitis C (HCV) is likely needed to truly shift restrictive pharmacy policy.

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“…Drug take‐back days serve as successful mechanisms to decrease the availability of prescription drugs for potential abuse and require community members to come together to dispose of expired medications in a safe and effective way 30 . Pharmacists can also offer group classes for chronic issues such as smoking cessation or diabetes, facilitate community brown bag events, teach young children about medication safety and poison control, provide education about the risks of substance abuse and misuse, increase access to sterile needles, improve access to naloxone, and provide hormonal contraceptives or pre‐exposure prophylaxis for human immunodeficiency virus (HIV) in the community setting 31–37 . Overall, intentionality must be balanced with reality as there may be some aspects of the social and community context that pharmacists may find challenging to address.…”

Section: Social and Community Contextmentioning

confidence: 99%

Pharmacist role in addressing health disparities—Part 2: Strategies to move toward health equity

Osae

Chastain

Young

2022

J Am Coll Clin Pharm

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Health disparities or extreme gaps of health across different groups of people result in poor outcomes for many Americans today. Pharmacists have an important role in addressing health disparities across many populations. Contextualizing root causes of gaps in health care and outcomes and identifying potential solutions to address those root causes are important initial steps clinical pharmacists can take to combat health disparities. PubMed and Web of Science were searched to identify articles published from inception until May 9, 2021. Articles in English were screened by title and abstract for relevance to clinical pharmacists' involvement in addressing health disparities. References from identified journal articles were also screened to identify further relevant articles. Utilizing the five domains of social determinants of health (SDOH) (economic stability, neighborhood and built environment, social and community context, education access and quality, and health care access and quality), actionable interventions to pursue health equity are presented. Pharmacists are in a unique position to make positive impacts on health disparities. By remaining intentional about decreasing unconscious biases and seeing past medications to the individual to identify potential barriers, pharmacists can bolster the movement toward health equity.

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The Role of Pharmacies in the HIV Prevention and Care Continuums: A Systematic Review

Cited by 30 publications

References 48 publications

Assessing the relationship between syringe exchange, pharmacy, and street sources of accessing syringes and injection drug use behavior in a pooled nationally representative sample of people who inject drugs in the United States from 2002 to 2019

Assessing the relationship between syringe exchange, pharmacy, and street sources of accessing syringes and injection drug use behavior in a pooled nationally representative sample of people who inject drugs in the United States from 2002 to 2019

A qualitative study on pharmacy policies toward over-the-counter syringe sales in a rural epicenter of US drug-related epidemics

Pharmacist role in addressing health disparities—Part 2: Strategies to move toward health equity

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