STI Quarterly

CDC eyes HIV testing in selected pharmacies

Your neighborhood pharmacy now offers checks for high blood pressure, cholesterol levels, and diabetes; testing for HIV might be the next addition in service. In a pilot project with the Centers for Disease Control and Prevention (CDC), 24 rural and urban pharmacies will undergo training to deliver confidential rapid HIV screening.

There are an estimated 1.1 million Americans who are living with HIV, and nearly one in five do not know it, says Kevin Fenton, MD, CDC's director of the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. Testing is the only way to identify the more than 200,000 Americans living with HIV who are unaware that they are infected, states Fenton. Because of their convenience and easy accessibility, community pharmacies and retail clinics can play a critical role in ensuring more Americans get tested for HIV, Fenton notes.

"Millions of Americans visit pharmacies every week, and research tells us that 30% of the U.S. population lives within a 10-minute drive of a retail clinic," says Fenton. "By bringing HIV testing into pharmacies, we believe we can reach more people by making testing more accessible and may also reduce the stigma associated with HIV."

Many places provide testing for HIV infection, such as local health departments, clinics, physicians' offices, hospitals, and sites specifically designed to offer such screening. Why add pharmacies to the list? Compared to healthcare settings and conventional testing sites, such locations might provide an environment that is more accessible to those who might be anxious about seeking their HIV status, CDC officials note.

"Our goal is to make HIV testing as routine as a blood pressure check," said Jonathan Mermin, MD, director of CDC's Division of HIV/AIDS Prevention, in a statement announcing the pilot project. "This initiative is one example of how we can make testing routine and help identify the hundreds of thousands of Americans who are unaware that they are infected."

During the two-year initiative, CDC will provide training for staff in community pharmacies and retail clinics in 12 urban areas and 12 rural areas with high HIV prevalence or significant unmet HIV testing needs. The training will focus on how to deliver rapid HIV testing and counseling and link those who are diagnosed with the virus to care and treatment.

Based on lessons learned during the pilot, CDC will develop a comprehensive toolkit that pharmacists and retail clinic staff from around the country can use as a model to implement HIV testing in their own settings, says Fenton. The project falls in line with CDC's 2006 testing recommendations,1 which advocate routine voluntary HIV screening as a normal part of medical practice.

Free testing offered

The pilot program kicked off in June 2012, with seven locations offering the free testing. Sites include Walgreens locations in Washington, DC, Chicago, and Lithonia, GA; East Pines Pharmacy in Riverdale, MD; Mike's Pharmacy in Oakland, CA; and a federal Indian Health Service location in Billings, MT.

Each of the locations has been allotted enough tests to check 200 to 300 people.2 The CDC said it planned to add 17 more pharmacies to the pilot program by the end of the summer.

Each pharmacy has a private area that is suitable for HIV screening. If a test comes out as a preliminary positive, the patient will be referred to a local health care provider for confirmation and care, as well as provided a list of community-based organizations to help address other health or social issues.

Opportunities exist

In 2010, an estimated 47,129 people were diagnosed with HIV infection in the United States; in that same year, an estimated 33,015 people were diagnosed with AIDS, the CDC reports.3 Since the epidemic began, an estimated 1,129,127 people in the United States have been diagnosed with AIDS.

Women accounted for 23% of estimated new HIV infections in 2009 and 25% of those living with HIV infection in 2008, the CDC notes. HIV infections among women are primarily attributed to heterosexual contact or injection drug use.3

"We know that getting people tested, diagnosed, and linked to care are critical steps in reducing new HIV infections," said Fenton in the program announcement. "By bringing HIV testing into pharmacies, we believe we can reach more people by making testing more accessible and also reduce the stigma associated with HIV."

References

  1. Branson BM, Handsfield HH, Lampe MA, et al; Centers for Disease Control and Prevention (CDC). Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings. MMWR Recomm Rep 2006; 55(RR-14):1-17.
  2. Stobbe M. Pilot program to offer free HIV testing in drugstores. USA Today, June 26, 2012. Accessed at http://usat.ly/Mz1Gbb.
  3. Centers for Disease Control and Prevention. HIV in the United States; at a glance. Fact sheet. Accessed at http://1.usa.gov/GMtMq.