Patients, Social Workers, and Pharmacists’ Perceptions of Barriers to Providing HIV Care in Community Pharmacies in the United States

Abstract

Retaining people living with HIV (PLWH) in clinical care is a global priority to end the HIV epidemic. Community pharmacies in the United States have structural influences on the success or failure of retention in HIV care by supporting patients’ complex needs. However, to date, barriers to retention in care in the community pharmacy setting have not been examined beyond pharmacy services of medication therapy management. We utilized the patient-centered medical home model to examine the barriers to HIV care in the community pharmacy setting. We utilized semi-structured interviews to collect data from 15 participants: five PLWH, five community pharmacists, and five social workers from a midwestern state. Interview data were transcribed and analyzed using directed content analysis. Four key themes emerged regarding the barriers that impact utilization of community pharmacy services by PLWH: the perception of the role of community pharmacists in HIV care, perceptions of pharmacists’ HIV knowledge, perceptions of pharmacy operation and services, and negative experiences within the community pharmacy space. Participants’ perceptions of solutions for improving HIV care in the community pharmacy focused on improving the relationship between pharmacists and patients, ensuring that the community pharmacy is a private and safe space for patients, and having a diverse pharmacy staff that is equipped to take care of the diverse and marginalized HIV population, such as transgender people.

Pharmacist-social worker interprofessional relations and education in mental health: a scoping review

“…Clinical psychiatric pharmacists may be positioned to provide this education given their post-doctoral training and board certification available ( e.g ., psychiatric pharmacy residency training, board certification in psychiatric pharmacy (BCPP)). Additionally, the role and impact of social workers should also be incorporated into pharmacy, especially their relationship to identify barriers to medication adherence are documented in other fields ( Tarfa, Pecanac & Shiyanbola, 2021 ). Future studies should also improve reporting transparency in noting the terminal degree of social worker ( i.e ., Bachelor of Social Work (BSW), MSW, DSW, PhD) and pharmacist (Bachelor in Pharmacy (B.Pharm.)…”

A Qualitative Systematic Literature Review of the Role of U.S. Pharmacists in Prescribing Pre-Exposure Prophylaxis (PrEP)

“…A recurrent theme among several studies included in this systematic literature review was two-fold, with enhancing privacy protections for patients and providing training to reduce stigma being identified as necessary for the successful implementation of PrEP services in pharmacy practice settings [ 13 , 22 , 23 ]. More evidence for promoting privacy in the community pharmacy setting was highlighted by Tarfa et al in their study focusing on people living with HIV [ 24 ]. Creating a safe and affirming environment for patients to seek specialized services in pharmacy settings, such as PrEP, requires proactive approaches to ensure privacy needs are met [ 25 ].…”

A qualitative inquiry into the patient-related barriers to linkage and retention in HIV care within the community setting

“… 49 , 70 Social workers have expressed a desire to work closely with pharmacists to address these limiting barriers PWH experience. 24 For pharmacists to engage in this recommendation, they first must become informed about the barriers including SDOH that their patients experience and can take strategic steps to become familiar with the resources within their community that can be used to address these patient barriers.…”

“… 22 Our study uniquely adds the perspectives of social workers who are trained to facilitate linkage and retention in care 23 and often work closely with pharmacists to address patient care needs. 24 , 25 The perspectives of pharmacists, social workers, and PWH are important for addressing barriers to care that impede progress towards ending the HIV epidemic.…”