HIV Voluntary Counseling and Testing (VCT) Should Pharmacists become more involved?
Lisa Bromfield, PharmD
According to the January to December 2012 HIV/AIDS Epidemic surveillance report in Jamaica, it is estimated that 34,000 persons are living with HIV and as many as 50% are unaware of their status. This number continues to increase over previous years. On the contrary, the annual number of reported AIDS deaths has decreased (e.g. Two hundred and sixty (260) AIDS deaths reported in 2012 compared to 665 in 2004). As stated in this report “The decrease in AIDS deaths is attributed to the introduction of public access to antiretroviral treatment in 2004, scaling up of the National Voluntary Counseling and Testing (VCT) Programme allowing for earlier diagnosis, availability of prophylaxis against opportunistic infections and improved laboratory capacity to conduct investigations such as CD4 counts, viral load and PCRs. These factors have resulted in a general improved quality of care.”
HIV Voluntary Counseling and Testing (VCT) is offered to individuals when they choose to undergo HIV/AIDS counseling so they are prepared to make an informed decision about whether to be tested for HIV and prepared for the results positive or negative. It is a tool to help prevent the spread of HIV. This involves a Pre-Test and Post-Test Counseling session.
Pre-Test Counseling: During this session the Counselor and client discusses behaviours that put the client at risk for HIV infection and how they can prevent it, prior to being tested. It addresses several areas such as:
- Current health problems
- What your risk of being HIV infected is
- What you know about HIV/AIDS
- What impact you think a positive, indeterminate or negative result would have on your life and how you think you would react to receiving them.
- What kind of support system you have including who you would be able to tell if you tested HIV antibody positive.
Post-Test Counseling: After they have had their test clients return to have this kind of counseling and learn his/her test result and talk about what these results mean. The counselor will:
- Let you express your feeling about being HIV antibody positive, negative or indeterminate.
- Help you to revisit the issues you raised during the pre test counseling session, including any plans you may have made.
- Discuss any immediate problems and help you to decide on a plan of action
- Answer any questions you may have and provide you with useful information
- Discuss positive living
Learning your HIV status has so many advantages. If an individual is positive it allows persons to seek Medical care early, stay healthy longer and to live positively with the virus. There is an opportunity to seek emotional support, control stress levels, avoid becoming reinfected and plan for the future. Persons will learn how to recognize signs of opportunistic infections so they can be treated quickly. If they are not infected with HIV, VCT can empower that individual to stay negative by gaining buy-in to avoid risky behaviour.
Pharmacists are called to play an important role within the HealthCare team that provides care for persons who test either Positive or Negative. Trained Pharmacists in VCT can offer their services at many sites including Private Pharmacies, Health Fairs and Public Institutions.
The development and use of rapid, point-of-care HIV tests have facilitated expansion of HIV testing services. Certification in HIV VCT and in Rapid Testing for Pharmacists allows us to expand our services, increase our visibility and to make an impact in the lives of people who often see HIV infection as a death sentence. So many creative approaches to service delivery have been implemented, including testing in mobile units and outreach testing in the community, schools, workplaces, religious facilities, and transport hubs. Can you envision Pharmacists as advocates for HIV/AIDS prevention? Can you see us as Educators and drivers of change, creating stronger partnerships with the MOH? What about increasing access points of care through offering Antiretrovirals, HIV VCT and Rapid Testing at our sites?
In 2014, 13 Pharmacists have made that step forward, training in VCT and Rapid Testing and Certified by Ministry of Health. Let’s join this team to be advocates for HIV/AIDS prevention and contribute to a Healthier Nation.