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Removing the stigma of HIV

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INTERPROFESSIONAL COLLABORATION
Zahrah Ali, a third-year PharmD candidate at WSU, provides an influenza vaccination during the HIV/Interprofessional Health Fair.

Stigmas surrounding health conditions—in particular, the misconception behind the Human Immunodeficiency Virus (HIV)—remain a major barrier for individuals, which deters them from accessing the health care they need. 


With modern medicine, treatments for HIV have proven to be effective and accessible, as well as to prolong life, so the assumption that HIV directly correlates with imminent mortality needs to cease. Pharmacists must contribute toward 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 the early stages of the disease. 


In September 2015, the Washington State University (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. 


Prepared to screen patients


Since this was the first time that HIV point of care services would be implemented as the primary focus of a health fair, our chapter 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 began 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 took 60 seconds to collect the specimen and an additional 60 seconds for the results to dry, which expressed reactive or nonreactive. Reactive samples indicate a need for an additional confirmatory blood test for HIV diagnosis. 


With each kit costing $10 and taking 2 minutes for results, incorporating HIV evaluation as another routine screening is a realistic expectation.


Successful health fair


After a year of working closely with the NAACP, SAN, and SRHD, the HIV/Interprofessional Health Fair took place at the end of October 2016 in the east central neighborhood of Spokane. Our 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, cholesterol screenings, hearing evaluations, BMI analysis, and blood pressure readings, 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 assessments provided, so that it may appear as another necessary screening for patients. When patients needed further consultation, they were escorted by a student pharmacist and SAN representative toward 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 that individual was sent 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 virus. Overcoming the HIV stigma is essential for patients to know their status for safer behaviors and lower transmission rates. It begins with removing personal misconceptions of the disease. 


 

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