Attitudes toward pharmacy-based HCV/HIV testing among people who use drugs in rural Kentucky

• Type of Material: Article
• Authors: Michelle Duong, Emory University; Chris Delcher, University of Kentucky; Patricia R Freeman, University of Kentucky; April M Young, University of Kentucky; Hannah Cooper, Emory University
• Language: English
• Date: 2021-03-05
• Publisher: WILEY
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2021 National Rural Health Association
• Final Published Version (URL): http://dx.doi.org/10.1111/jrh.12564
• Title of Journal or Parent Work: JOURNAL OF RURAL HEALTH
• Volume: 38
• Issue: 1
• Start Page: 93
• End Page: 99
• Grant/Funding Information: This work was supported by the National Institute on Drug Abuse (UG3DA044798/UH3DA044798: PIs Young and Cooper; K01DA048174: PI Lancaster).
• Keywords: Science & Technology; rural health care; HIV; Life Sciences & Biomedicine; HCV; pharmacy services; SALES; injection drug use; Health Policy & Services; HEPATITIS-C; HIV PREVENTION; HCV testing; ACCESS; Public, Environmental & Occupational Health; INJECT DRUGS; SYRINGE EXCHANGE PROGRAMS; Health Care Sciences & Services; NALOXONE; UNITED-STATES; INCREASES

Abstract

Purpose: Rural areas of the United States have experienced outbreaks of human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infections among people who use drugs (PWUD). Pharmacy-based interventions may play a crucial role in prevention and entry into care, especially when traditional health care access is limited. The willingness of rural PWUD to use pharmacies for HIV/HCV-related services remains unknown. The purpose of this study was to describe the factors associated with the perceived likelihood of participating in free pharmacy-based HIV and HCV testing among PWUD living in rural Kentucky. Methods: Baseline data from the CARE2HOPE study in five Appalachian counties in eastern Kentucky were used. Participants were recruited using respondent-driven sampling and completed interviewer-administered surveys. Guided by the Andersen and Newman Framework of Health Services Utilization, we examined distributions and correlates of items regarding willingness to participate in free pharmacy-based HIV/HCV testing using logistic regression. Analyses included individuals who reported being HIV (N = 304) or HCV (N = 185) negative. Findings: Seventy-five percent of PWUD reported being “very likely” to participate in free pharmacy-based HIV testing and 80% for HCV testing. Two factors were associated with being less willing to participate in free HIV testing: PWUD who previously tested for HIV (OR: 0.47, CI: 0.25–0.88) and PWUD who obtained a high school diploma or equivalent compared to those who completed less (OR: 0.50, CI: 0.26–0.99). Conclusion: Free pharmacy-based HIV and HCV testing was invariably acceptable among most of the rural PWUD in our sample, suggesting that pharmacies might be acceptable testing venues for this population.