Pharmacists Ready to Help with OTC HIV Test

Community pharmacists interviewed for a recently published study were eager to play a role in counseling patients who use over-the-counter HIV tests.

As pharmacists continue to become more involved in patient care, a new study finds that many community pharmacists feel they are in a prime position to offer counseling and support to patients who purchase over-the-counter rapid HIV test kits.

The study, presented on July 16, 2013, at the STI & AIDS World Congress in Vienna, Austria, and published in the July 2013 issue of AIDS and Behavior, enrolled 17 community pharmacists from Indiana to explore opinions on the sale of OTC HIV tests. Participants were interviewed in person or by telephone between May and September 2012, during which time the FDA approved OTC sale of the rapid HIV test kit.

All pharmacists interviewed agreed that rapid HIV testing was likely to lead more people to learn their HIV status. More testing was viewed as a positive, given that 20% of people infected with HIV in the United States are unaware of their disease status. However, many pharmacists included in the study also felt that, in addition to selling the test, they needed to help direct patients to appropriate treatment as well since only 24% of those living with HIV have the virus under control.

“So I think there’s a trade-off,” one pharmacist told researchers. “Do you want to test more people, or do you want to make sure the people that you test that are positive get into the correct system to get treatment?”

All participants discussed the importance of counseling at the point of sale to help answer patient questions and to direct them to suitable care resources. Given the fact that patients who use the test may feel isolated once they receive its results, all pharmacists in the study saw discussing the test with patients as in important responsibility. For some pharmacists, this consultation would include reviewing the test procedure and answering questions about its accuracy, while others felt it was important to establish a relationship with patients to make them feel comfortable enough to return and ask questions about the results.

In order to increase the chances for counseling, pharmacists felt the HIV test should be displayed close to the pharmacist, either behind or in front of the counter.

“Maybe if it was kept behind the pharmacy, for some people that might deter them from wanting to purchase it,” one pharmacist in the study said. “But the other big thing too, if it’s held behind the counter, is that once they purchase the test at that point, you’re able to say, ‘[W]ell if you have questions or concerns once you get your results, we’re here for you to talk to;’ and be able to offer more than they thought they would get just purchasing the test.”

The study’s findings suggest that pharmacists have the opportunity to offer initial information about the OTC rapid HIV test and to provide counseling to help those who test positive seek treatment. The role of pharmacists as health consultants, embraced by all participants, reflects the expanding role of the pharmacist and changes in pharmacy practice that have taken place over the past decade, the researchers note, adding that future research should include a larger and more diverse sample of pharmacists and should further explore the unique position pharmacists can play in counseling patients regarding OTC rapid HIV tests.

“Exploration should include strategies to reinforce system sustainability, such as reimbursement to pharmacists who offer test consultation,” the researchers write. “This kind of systems thinking is paramount if we are going to increase the number of people who know their status and also increase the number of people in HIV treatment.”