Patients with HIV Support Clinic-Based Contraceptive Care by Pharmacists
New research shows that women with HIV infection and who happen to be high users of contraception support receiving contraception prescriptions from pharmacists.1
“We have the University of New Mexico Health Sciences Center that provides care for people with HIV, and patients get all of their care there,” says Alexandra Herman, PharmD, study co-author and a clinician educator assistant professor at the University of New Mexico College of Pharmacy. “Only 10% of their 1,400 patients are women. Most focus on men because traditionally they’ve been the largest proportion of the population impacted by HIV. But that is changing with more women diagnosed with HIV.”
That presented the question of what the clinic could do for women. Providing improved access to contraception was the answer. The next step was to determine how to improve access within the clinic’s resource constraints. One possible answer is for pharmacists to prescribe contraception, a service they have been able to provide in New Mexico since 2017.
“They can prescribe vaccination, TB testing, smoking cessation, medications, and other things. Contraception was added in 2017,” Herman explains. “We have a separate licensure for pharmacist clinicians — pharmacists who have extra training.”
Herman and colleagues asked patients what they thought about pharmacists in the clinic providing contraception care. They learned that patients were unaware that pharmacists could prescribe contraceptives.
“We’d tell them the protocol and ask them what they think about it, and they [said they] were all for it once they heard about it,” Herman says. “Patients seem to trust pharmacists.”
People with HIV know that pharmacists are well-trained and can answer their questions about antiretroviral medication. “We rank pretty high as trusted professionals, and that was true with our population that we studied,” Herman says.
The next step is for the clinic to implement a pharmacist-prescribed contraceptives program. “This is not something we’re doing yet, but now that it’s on everyone’s minds, this is something we want to do,” Herman says. “We need to figure out how to implement it and provide it for patients.”
The clinic’s patients say they love the care they receive there and appreciate the convenience of visiting the clinic for all their healthcare needs, Herman says.
Although the women surveyed largely said they did not encounter problems obtaining the contraception they desired, they still liked the idea of extra convenience through a pharmacist prescription of any contraceptive except for an implant or device.
“A pharmacist could prescribe [or distribute] a pill, patch, ring, Depo shot, and nonhormonal methods like condoms and spermicides,” Herman says. Patients who want an intrauterine device or implant could be referred to a physician.
Contraceptive counseling and discussions of patients’ sexual and reproductive health would not be a problem for the clinic’s pharmacists.
“They’re not shy about any of that,” Herman explains. “We have a good training program for our pharmacists. We train all of our students in the third year of medical school, and any student from UNM could be certified.”
Most of the pharmacy students and pharmacists are comfortable with counseling patients on sexual health and contraception and are prepared to answer patients’ questions.
“Pharmacists want to prescribe contraceptives,” Herman says. “They see themselves as a valuable resource for their patients.”
- Benitez X, Aragon K, Jakeman B, et al. Patient perspectives and needs regarding contraception in female patients with HIV: A qualitative study. J Am Pharm Assoc (2003) 2023;S1544-3191(23)00373-4.
New research shows that women with HIV infection and who happen to be high users of contraception support receiving contraception prescriptions from pharmacists.
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