Are You Ready to Counsel on Pre-Exposure Prophylaxis?

Concerted efforts to eradicate HIV have led to a significant decline in new cases. However, certain individuals remain at elevated risk, and experts in the field have looked for ways to protect these people from infection. One such method is pre-exposure prophylaxis, or PrEP. When individuals who are at risk for HIV use PrEP, and use it appropriately, risk of infection is significantly lowered.

The Journal of the American Pharmacists Association has published results of a cross-sectional survey study that examines pharmacists' knowledge and experience, perceptions, attitudes, and training needs with regard to PrEP. The research team, academics from the University of Minnesota College of Pharmacy, set out to determine what pharmacists know about PrEP, and what they need to know. Their target audience was community pharmacists.

A total of 347 community pharmacists responded to the study. Pharmacists were very likely to be familiar with PrEP, with 76% understanding that PrEP has benefits for certain high-risk populations. Awareness did not translate to knowledge, however. Approximately half of respondents did not know that emtricitabine and tenofovir disoproxil fumarate is FDA-approved for PrEP. About 1/3 of respondents had actually dispensed PrEP within the last few years.

In addition, a majority of respondents (more than 70%) were unfamiliar with the CDC guidelines for PrEP. And only 21% reported that their knowledge was broad enough to counsel patients about PrEP.

Only 33% had engaged in HIV continuing education within the previous 2 years, and those who had completed courses were more knowledgeable about PrEP. As expected, the pharmacists who had the best baseline knowledge of HIV and PrEP were those who self-identified as HIV specialists.

Most pharmacists reported that, in general, their confidence levels were such that they hesitated to counsel about the medication and behavior modification. Two areas of specific concern were identifying appropriate candidates, and patient adherence.

The researchers report that it is imperative for basic education in pharmacy school and in continuing education activities. Pharmacists can find the CDC's comprehensive array of resources and education for professionals by visiting its website.

Reference

Okoro O, Hillman L. HIV pre-exposure prophylaxis: Exploring the potential for expanding the role of pharmacists in public health. J Am Pharm Assoc (2003). 2018 May 19. pii: S1544-3191(18)30178-X.