1 Division of Disease Prevention, Virginia Department of Health, Richmond, VA, USA.
Public Health Rep. 2018 Nov/Dec;133(2_suppl):34S-42S. doi: 10.1177/0033354918801026.
As part of the Care and Prevention in the United States Demonstration Project (2012-2016), which aimed to reduce HIV-related morbidity and mortality among racial/ethnic minority groups in 8 states, the Virginia Department of Health (VDH) funded Walgreens to provide HIV testing in retail pharmacies in areas with large racial/ethnic minority communities and high rates of poverty. We describe this program and summarize its outcomes. We hypothesized that (1) offering walk-in HIV testing outside of traditional business hours and alongside other point-of-care tests in retail pharmacies would increase rates of first-time testers and (2) using data on social determinants of health associated with higher rates of HIV infection to locate test sites would increase the identification of people who were previously undiagnosed.
Using 2010 US Census data and 2007-2011 five-year population estimates from the American Community Survey, VDH selected 32 Walgreens stores located in census tracts where at least 30% of the population was black and/or Hispanic/Latino and/or where at least 20% of the population was living at or below the federal poverty level. Pharmacists administered the INSTI HIV-1/HIV-2 Rapid Antibody Test. Clients with a reactive test result were linked to confirmatory testing and medical care.
Between June 1, 2014, and September 29, 2016, Walgreens pharmacists performed HIV tests on 3630 clients, of whom 1668 (46.0%) had either never been tested or were unsure if they had been tested. Of all clients tested, 30 (0.8%) had a reactive test result. Of 26 clients who also had positive confirmatory testing, 22 (84.6%) were linked to care. The mean cost per person tested was $41.79, and the mean cost per reactive result was $5057.
Retail pharmacies may be an effective venue for those who have never been tested for HIV to access HIV testing, particularly if the pharmacies are located in priority areas or where community-based organizations are unable to operate.
作为 2012-2016 年“关爱与预防在美国示范项目”的一部分，该项目旨在减少 8 个州的少数族裔人群的 HIV 相关发病率和死亡率，弗吉尼亚州卫生部（VDH）资助沃尔格林（Walgreens）在少数族裔社区和贫困率高的地区的零售药店提供 HIV 检测。我们描述了这个项目，并总结了它的结果。我们假设（1）在传统营业时间以外以及在零售药店提供其他即时护理检测的同时提供现场 HIV 检测，将增加首次检测者的比例；（2）利用与 HIV 感染率较高相关的健康社会决定因素的数据来定位检测点，将增加发现以前未被诊断出的人的比例。
利用 2010 年美国人口普查数据和 2007-2011 年美国社区调查的五年人口估计数据，VDH 选择了 32 家位于至少 30%的人口为黑人且/或西班牙裔/拉丁裔的沃尔格林门店，或者至少 20%的人口生活在贫困线以下的人口普查区。药剂师进行 INSTI HIV-1/HIV-2 快速抗体检测。对有反应性检测结果的客户进行确认检测和医疗护理。
在 2014 年 6 月 1 日至 2016 年 9 月 29 日期间，沃尔格林的药剂师对 3630 名客户进行了 HIV 检测，其中 1668 名（46.0%）从未接受过检测或不确定是否接受过检测。在所有接受检测的客户中，有 30 人（0.8%）的检测结果呈阳性。在 26 名也有阳性确认检测结果的客户中，有 22 名（84.6%）与护理机构建立了联系。每位受检者的平均检测费用为 41.79 美元，每位有反应性检测结果的受检者的平均检测费用为 5057 美元。
零售药店可能是那些从未接受过 HIV 检测的人进行 HIV 检测的有效场所，特别是如果药店位于优先地区或社区组织无法运营的地区。
