Screening for Potential PrEP Users at Retail Pharmacies

In a pilot project, customers were surveyed about HIV risk behaviors to gain further insights and assessed for potential PrEP utilization.

Medical counseling remains paramount to offering education to the general public. Long considered one of the most trustworthy in their occupation, pharmacists have a unique opportunity to have health conversations with people and counsel them when appropriate.

The adaption of PrEP therapy is one area within HIV prevention that has been increasing overall, but still needs help in greater utilization amongst appropriate populations.

As of 2019, Kenya had 1.5 million people living with HIV, a 4.5% prevalence rate in adults aged 15-49, and 42,000 new infections, according to Avert. With that country’ high prevalence, yet people dealing with issues of stigma and long wait times in clinics, public health officials were looking for other potential solutions in the possibility of understanding HIV-associated behaviors and offering another option for PrEP counseling.

Investigators in Kenya set up a pilot program where they engaged customers at four retail pharmacies who were there seeking sexual and reproductive health (SRH) services, such as family planning. These customers were screened for PrEP eligibility, use the PrEP RapidAssessmentScreeningTool(RAST), which is used in public HIV care clinics in Kenya.

From November 2020 to February 2021, 227 customers completed RAST so as to determine PrEP eligibility.

“The majority (80%) of clients reported some behavior associated with HIV acquisition risk,” the investigators wrote. “Over half of clients (55%) reported inconsistent condom use, more than half (51%) reported not knowing the HIV status of their sexual partner(s), and almost a third (28%) reported multiple sex partners.”

With these findings, the investigators believed there was an opportunity for pharmacies to play a role with PrEP utilization.

“The prevalence of behaviors associated with HIV risk was high among clients accessing SRH services at retail pharmacies in Kenya,” investigators reported. “These findings suggest that the delivery of PrEP at retail pharmacies has great potential to expand the reach of PrEP to populations at HIV risk in Kenya and similar settings.”

The findings were presented at the 11th International AIDS Society Conference on HIV Science.