Correlates of pharmacy based HIV testing referral utilization in a high-risk community

Background: Black and Latinos face limited access to healthcare services. Expanding HIV testing referrals into pharmacies may improve HIV testing for people with less healthcare access. The Expanded Syringe Access Program... [ view full abstract ]

Background: Black and Latinos face limited access to healthcare services. Expanding HIV testing referrals into pharmacies may improve HIV testing for people with less healthcare access. The Expanded Syringe Access Program (ESAP) in pharmacies may provide access to those at highest risk for HIV and may be positioned to provide in-pharmacy HIV testing referral and linkage to care in at-risk communities.

Objective: This analysis aims to assess the correlates of utilizing HIV testing referrals provided by pharmacies among customers recruited from a neighborhood with high HIV prevalence.

Methods: We examined the associations between demographic and risk behaviors with the utilization of HIV testing referrals among a racially/ethnically diverse sample of participants (n=205). Data for the analysis come from a cross-sectional study among customers of ESAP pharmacies in Harlem, New York City (2010-2011). Binary logistic regression models were constructed to examine the extent to which the predictors explained the likelihood of utilizing HIV testing referrals.

Results: Most participants were male (65.9%), Black and Latino(88.3%), and had used hard drugs (89.8%); 19.5% utilized the HIV testing referrals provided. Bivariable analyses indicated negative associations between ever smoking crack, ever smoking heroin, and injecting heroin in the last 3 months with the utilization of HIV testing referrals; while older age, being male, having higher levels of education, and engaging in condomless sex were found to be protective. Controlling for sex/gender and engaging in condomless sex increased the likelihood of utilizing HIV texting referrals more than 3 times, while having smoked crack reduced this likelihood by approximately 62%.

Conclusion: Findings suggest that using the ESAP structure for HIV referrals may be a complement to healthcare-based testing. In-pharmacy HIV testing referrals may be part of more comprehensive strategy to promote HIV testing in high-risk populations. More research is needed to continue exploring in-pharmacy strategies.