By: Mark Nguyen, Class of 2019, APhA-ASP Chapter, WSU College of Pharmacy
Stigmas surrounding health conditions remain a major barrier for individuals, which deters them from accessing the health care they need; in particular, the misconception behind the Human Immunodeficiency Virus (HIV). Across the state of Washington, the amount of new HIV cases rate between the years of 2011 to 2015 has remained stagnant with an average of 6.84 cases per 100,000 population, according to the 2016 Department of Health HIV Surveillance Semiannual Report. The average value for all ethnicities doesn’t seem to be significant at first glance, but by separating the rates for each race, there is a staggering trend during the same timeframe. The same report indicates that African Americans, Hispanics, Asians, and Whites, have 38.1, 8.8, 5.8, and 5.1 cases per 100,000 population, respectively. The African American discrepancy is consistent with the national average, and is actually lower in the Spokane county in comparison to the country’s medium.
With modern medicine, treatments for HIV have proven to be effective, accessible, and prolong life; the assumption that HIV directly correlates with imminent mortality needs to stop. As a health care team, we must contribute towards the growing effort to make individuals aware of their status before they unknowingly pass the virus to someone else, or miss an opportunity to make use of the treatments available to them in early stages of the disease. During September 2015, the Washington State University’s American Pharmacist Association – Academy of Study Pharmacists (WSU APhA-ASP) Chapter began a partnership with the Spokane National Association for the Advancement of Colored People (NAACP) organization on an initiative to target African Americans and mask the stigma behind HIV through an interprofessional health fair.
Since this was the first time HIV point-of-care services would be implemented as the primary focus of a health fair, the WSU APhA-ASP reached out to the Spokane AIDS Network (SAN) and Spokane Regional Health District (SRHD) to receive proper training on screening, counseling, triaging of patients, and familiarization with difficult scenarios. After three training sessions, there were a total of 15 student pharmacists prepared to begin a legacy on an initiative that has never been done on the health science campus in Spokane.
The screening process begins with an evaluation of the patient’s history and risk factors, in addition to an educational component of reducing the likelihood of exposing oneself to the virus. In order to collect a patient’s sample, a lancet was placed on their finger, where the blood was collected via a pipette, and then transferred to three separate solutions in a membrane unit. It takes 60 seconds to collect the specimen and an additional 60 seconds for the results to dry, which indicate reactive or non-reactive. Reactive samples indicate a need for an additional confirmatory blood test for a HIV diagnosis. With each kit costing $10 and taking two minutes for results to complete, incorporating this as another routine screening is a realistic expectation.
After a year of working closely with NAACP, SAN, and SRHD, the HIV/Interprofessional Health Fair finally took place at the end of October 2016 in the East Central neighborhood in Spokane, Washington. The WSU APhA-ASP Chapter collaborated with the WSU Nursing, WSU Nutrition and Exercise Physiology, WSU Speech and Hearing, and WSU Health Policy Administration programs to offer additional point of care services, including vaccinations, blood sugar assessments, blood pressure readings, hearing evaluations, BMI analysis, cholesterol screenings, in addition to cardiovascular and diabetes education. The HIV screenings were performed in the same room as the other services offered and conducted behind dividers. It was our intention to not have the HIV testing concealed from the other services provided, so it would appear as another necessary assessment for at risk individuals. When patients needed further consultation, they were escorted by the screening student pharmacist and SAN representative to a separate room. The SRHD had the responsibility of bringing equipment for confirmatory tests in the case of a reactive test. There were 16 patients screened for HIV during this health fair with 1 reactive result and the individual was arranged to be triaged for a confirmatory test, counseling, and follow up with the SRHD.
By making the HIV screening seem routine alongside the other assessments and surrounding the health fair with the necessary support, it created an environment that was accepting of the disease. Overcoming the HIV stigma is essential for patients to know their status for safer behaviors and lower transmission rates. As the most accessible health care provider, it begins with removing our personal misconceptions of the disease.