Medical researchers at Albert Einstein College of Medicine of Yeshiva University in New York found local pharmacies can serve as venues to offer rapid HIV screening and get medical care for those who test positive. The team from Einstein College and its affiliated Jacobi Medical Center in the Bronx published its findings in this month’s issue of the journal AIDS Patient Care and STDs.
The Centers for Disease Control and Prevention reports that the number of new HIV cases each year remains stable at about 50,000 a year, with more than 1.1 million American living with HIV, and of those about 1 in 5 — some 240,000 — are unaware they are infected.The rate of new infections among African-Americans is 68.9 per 100,000 and among Hispanics is 27.5 per 100,000, 8 times and 3 times respectively of the rate for whites (8.7 per 100,000)
The Bronx, where Einstein College and Jacobi Medical Center are located, has large proporations of minorities in its population, as well as one of the highest HIV rates in the U.S. The team of lead author Yvette Calderon, Jason Leider, and Ethan Cowan, with colleagues from Jacobi Medical Center, tested the potential role of community pharmacies in reaching at-risk populations for HIV testing, diagnosis, and care.
The Einstein/Jacobi team recruited five pharmacies in 2009 to 2011, three in the Bronx and two in Manhattan, located in zip codes with among the highest reported rates of HIV infection. The researchers trained public health advocates — membersof the community who take part in public health outreach — to approach people in the pharmacies or on nearby sidewalks to offer HIV testing.
Pharmacy customers who agreed to participate were given a rapid HIV test, from a saliva swab, with results reported back in 20 minutes. Participants were asked to fill out a form, while results were being prepared, asking about HIV risk factors and their satisfaction with the HIV test. Participating customers would also receive counseling on HIV risk reduction, based on their responses on the forms.
If the tests returned a positive result, the public health advocates would offer to escort the pharmacy customer to a nearby HIV clinic to see a medical specialist (participants could decline the escort offer). On average, report the researchers, customers who tested positive saw an HIV specialist within an hour of the pharmacy test.
During the study, the Einstein/Jacobi team tested 2,030 individuals for HIV infection, of which 6 returned a positive result, with 5 of the 6 agreeing to be escorted to an HIV clinic. Further tests showed the customers testing positive were in the early stage of infection, with an average CD4 or T-cell count of 622 per milliliter. CD4 counts of 700 or higher are considered typical for people who are HIV negative.
Calderon notes that pharmacies can serve a valuable role in curbing HIV infection in at-risk communities. “While New York pharmacies are not currently allowed to provide blood tests or medical care,” says Calderon, “they do administer vaccines and provide wellness help. Many area residents view the pharmacists as trustworthy and more accessible than doctors and go to them for advice.”
Calderon tells more about the study in the following video.
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