Pharmacists role in communicating health and medicines information to prevent HIV transmission
Author: Dr Adam Pattison Rathbone JP MRPharmS SFHEA
Newcastle University, Faculty of Medical Sciences, School of Pharmacy, England, UK
Email: Adam.rathbone@ncl.ac.uk
Communicating health and medicines information is an important role for pharmacists and pharmaceutical scientists. Health and medicines information can be communicated between family and friends, peers or via healthcare professionals, yet a younger generation may more readily obtain information about medications online. Access to information online can improve health literacy, lead to increased awareness about treatments and contribute to behaviour and policy change.
Although more recent attention has focused on coronaviruses due to the COVID19 pandemic, other viruses, such as HIV remain prevalent within the UK and overseas. Human Immunodeficiency Virus-1 (HIV) is an infectious virus prevalent and intractable across the globe. Information about medications for HIV typically focus on treatment, however information aout pre-exposure prophylaxis (PrEP) for is increasing. PrEP involves using anti-retroviral medications routinely prior to the exposure to the virus or on-demand shortly before and after exposure. PrEP is available as a solid oral dosage form, containing tenofovir and emtricitabine, as a generic formulation and as the brand formulation Truvada (see https://www.tht.org.uk for more information). PrEP has been shown to be effective if taken regularly, one tablet each day, or when needed for short durations — two tablets 2–24 hours prior to sex, one tablet 24 hours after sex and a further tablet 48 hours after sex (Molina et al. 2015). Although evidence to support the use of PrEP is promising, access is currently limited.
Evidence from a limited number of jurisdictions has shown pharmacists can have a key role in supporting the use of these medications. A recent systematic review by the World Health Organization demonstrated that community pharmacists may have a role in supply PrEP in some jurisdictions (see https://bmjopen.bmj.com/content/12/2/e054121.abstract for more information). Although the data were largely heterogenous, the review synthesised six case studies that indicated pharmacists could feasibly provide PrEP over the counter. However, this only demonstrated the role of pharmacists in the US, Kenya and South Africa. Further work is needed to investigate and explore the role of pharmacists to support PrEP use across jurisdictions.
Pharmacists and pharmaceutical scientists in jurisdictions where PrEP is currently not supplied in community pharmacy settings, may have a role in widening access to PrEP for those most in need. For example, in the UK, PrEP is only available through specialist sexual health services. Access to sexual health services may still be stigmatised, which may dissuade some groups from accessing services to obtain PrEP. For example, straight women and people from ethnic minority backgrounds are less likely to use sexual health clinics (see https://sti.bmj.com/content/94/5/384 for more information). People from these communities may need to access PrEP from places with less stigma, such as community pharmacies. There are growing calls for access to PrEP to be widened (see http://www.iwantprepnow.co.uk for more information). However, if PrEP cannot be supplied by pharmacists, what can pharmacists and pharmaceutical scientists do to help?
Pharmacists have an opportunity to educate policy makers, legislators, and the public about PrEP. On 14th July, an online workshop was held in Newcastle University, UK which invited delegates with an interest in PrEP to share their expertise and experiences. Delegates and speakers were from a wide variety of backgrounds, including health professionals, patient representatives, academics, manufacturers, legislators, charities and activists (see http://research.ncl.ac.uk/prepnow for more information). The role for pharmacists at this event was to coordinate, engage and interest stakeholders and people about medication use to share information about PrEP. Pharmacists at this event were still integral to the communication of medicines information, by providing opportunities for information exchange between practitioners, policy makers and patients.
Pharmacists and pharmaceutical scientists then across the world, whether PrEP is available in your jurisdiction or not, have an opportunity to engage with information about PrEP — to be advocates for information dissemination, policy change and widening access to PrEP, supporting the reduction of HIV transmission world wide.
