Study seeks HIV prevention medicine access in private pharmacies for married men
Allowing private pharmacies to dispense HIV prevention drugs may increase the number of Kenyans accessing and using the drugs. FILE PHOTO | SHUTTERSTOCK
A new study shows that allowing private pharmacies to dispense HIV prevention drugs may increase the number of Kenyans accessing and using the drugs, especially older men with disposable income, an important step toward reducing new infections.
A pilot conducted at five private pharmacies in Kenya: three in Kiambu and two in Kisumu counties, shows that supply of oral HIV pre-exposure prophylaxis, commonly known as PrEP, at chemists may reduce barriers to accessing the drugs, which include the stigma associated with walking into an HIV clinic, long wait times and overcrowding at public hospitals.
“Despite the availability of free HIV testing, treatment and daily PrEP at public healthcare facilities, HIV incidence persists above levels of epidemic control. Barriers to PrEP services include the stigma associated with visiting facility-based HIV clinics, limited hours of facility operation, and long travel distances to and time waiting at healthcare facilities,” notes the Stand-Alone Model For Delivery Of Oral Hiv Pre-Exposure Prophylaxis In Kenya: A Single-Arm, Prospective Pilot Evaluation Study, published in the Journal of International Aids Society.
PrEP drugs are used to reduce the risk of HIV infection.
In the study, more Kenyan men visited the pharmacies to receive PrEP services, including testing, paying Sh300.
“Some 84 percent reported sexual partners with unknown HIV status and 53 percent reported multiple sexual partners,” the study shows.
“Most travelled less than 15 minutes to the pharmacy, and learned of the pharmacy-delivered PrEP services by informal word-of-mouth referral,” it noted.
Among many Kenyans, private pharmacies are typically the first place they seek healthcare.
“Pharmacies already provide many preventive and curative sexual and reproductive health services, such as contraception and sexually transmitted infection treatment,” the authors noted.
Infection burden
When Kenya first rolled out PrEP, it mainly focused on HIV-negative individuals in serodiscordant relationships [a couple in which one partner is HIV-positive and one partner is HIV-negative], married people, and young women because eight out of 10 new HIV infections currently occur among adolescent girls and young women aged 15 to 24.
However, the study shows, over half of the Kenyans seeking PrEP were men, and less than half were married.
The unmet need
“Pharmacy-delivered PrEP services may address a previously unmet need among older men who are interested in and could benefit from PrEP. Reaching this population is especially important in Africa, where young women —a priority HIV prevention population—often acquire HIV from older male partners.
Pharmacy-delivered PrEP services may also be a good fit for older men who, compared to other populations, are more likely to have disposable income that could be used to purchase PrEP services,” the study noted.
Risky behaviours
The authors noted that men who came in for PrEP services, which included HIV testing, exhibited more behaviours associated with HIV risk acquisition. A substantial number, both men and women, had a partner and a casual partner.
"Compared to female clients, male clients reported a significantly higher prevalence of multiple sexual partners and recent engagement in sex with alcohol," the study shows.
