August 8, 2013
Researchers at Albert Einstein College of Medicine of Yeshiva University, in Bronx, N.Y., investigated whether individuals would agree to HIV testing if they could access it at community pharmacies. Yvette Calderon, MD, professor of clinical emergency medicine, associate dean for Einstein's Office of Diversity Enhancement, and adult urgent care director at Jacobi Medical Center, surmised that one of the reasons why the number of new HIV infections in the United States remained at approximately 50,000 for more than a decade was the lack of access to testing. She noted that groups with the highest HIV burden -- low-income and minority groups -- had the lowest access to healthcare.
Calderon and colleagues tested a different way of offering testing to low-income and minority groups. They partnered with five community-based pharmacies in the Bronx and Manhattan to test high-risk and difficult-to-reach individuals. The researchers used public health advocates (PHAs) to offer HIV testing to people in pharmacies and on sidewalks and to administer the oral rapid test to those who accepted. The rapid test kits provided results in 20 minutes. Participants completed an HIV-risk factor and test satisfaction questionnaire while waiting for their results, and the PHA counseled them about risk reduction. If the participant received a positive test result, the PHA offered to take them to an HIV clinic nearby to meet with an HIV specialist. Participants were free to accept or decline the offer.
Throughout 294 testing days, PHAs tested 2,030 persons, six of whom tested HIV-positive. Five of the six allowed the PHA to accompany them to the clinic, where additional testing showed that their diagnosis came at an early stage of infection. Calderon concluded that the results showed that pharmacies could supplement the healthcare system, particularly in lower-income neighborhoods, by offering a convenient way for people to know their HIV status and get treated.
The full report, "Counselor-Based Rapid HIV Testing in Community Pharmacies," was published online ahead of print in the journal AIDS Patient Care and STDs (2013; doi:10.1089/apc.2013.0076).