CDC Calls on Pharmacists to Aid HIV Epidemic

While new data from the CDC recommends screening for people between the ages of 13 and 64 years of age, only 40% have ever been tested, according to data in the Morbidity and Mortality Weekly Report (MMWR).

“The new data, released on National HIV Testing Day, underscore the urgent need to scale up HIV testing to end America’s HIV epidemic,” the CDC states. “The analysis of 2016-2017 data from a national population-based survey suggest most people are not getting the recommended screening, even in areas with a high burden of HIV.”

The study’s release follows an initiative spearheaded by the Trump Administration calling for a 75% reduction in new HIV cases over the next five years and a 90% reduction in a decade. The Health and Human Services (HHS) initiative “Ending the HIV Epidemic: A Plan for America” is asking for $291 million in FY2020 to begin a three-phased approach that includes:

• Investing in geographic hotspots through programs like the Ryan White HIV/AIDS Program and a community health center program to make pre-exposure prophylaxis (PrEP) more widely available to a high-risk population.

• Using data to address healthcare needs at the local level

• Establishing local teams to expand HIV prevention and treatment.

The initiative will target geographic areas with the highest number of new HIV cases including the 50 local jurisdictions and seven states with a high proportion of new HIV cases in rural areas, specifically: Alabama, Arkansas, Kentucky, Mississippi, Missouri, Oklahoma, and South Carolina.

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If funded, the HHS-led initiative is calling on CDC to take an active role with the Health Resources and Services Administration, Indian Health Service, NIH, Office of the HHS Assistant Secretary for Health, and the Substance Abuse and Mental Health Services Administration.

The most recent CDC findings on HIV include:

• Less than 30% of people considered “at risk of acquiring HIV” were tested in the past year.

• In the 50 local jurisdictions where more than half of HIV diagnoses occur, less than 35% of people recommended for annual HIV testing were tested in the past year.

• Only 26% of people living in rural areas (who were recommended for testing) had been tested for HIV in the past year.

CDC recommends people with specific risk factors be screened at least once a year. That includes:

• Sexually active gay, bisexual and other men who have sex with men;

• People who inject drugs;

• Anyone who has had more than one sex partner since their last HIV test;

• People who have been diagnosed with another sexually transmitted infection, hepatitis, or tuberculosis

“A negative HIV test result can lead to prevention options like PrEP, a medication to prevent HIV acquisition,” CDC says. “A positive result should lead that person to care and treatment, ideally on the day the diagnosis is made.

“HIV treatment reduces the amount of HIV in a person to a very low level-known as viral suppression or having an undetectable viral load. People who reach and maintain viral suppression have effectively no risk of transmitting HIV to others through sex,” CDC states.

The new study mentions promising novel approaches to increase access to HIV testing. These approaches included integrated and routinized HIV screening in a variety of healthcare settings, as well as scaling up partner notification and social/sexual network screening strategies, and mass distribution of HIV self-tests.

According to the ASHP, pharmacists play a key role in helping to prevent and manage HIV, including:

• HIV testing

• Treatment of HIV infection

• Treatment of HIV in key patient populations

• HIV treatment failure

• Management of HIV disease state complications

• Treatment and prevention of opportunistic infections

• Prevention of HIV infection

• HIV education

• Social services and HIV infection

• Professional engagement