California pharmacists willing to prescribe HIV prevention and contraception, but few do

A new study from the California HIV/AIDS Policy Research Centers, in collaboration with the Center on Reproductive Health, Law, and Policy, Birth Control Pharmacist, and the California Society of Health-System Pharmacists, finds that more than 90% of California pharmacists surveyed believed access to HIV prevention medications and contraception in pharmacies is important.

Using data from an online survey of 919 California pharmacists and pharmacy students, researchers examined attitudes, knowledge, and preferences around the provision of HIV prevention and other sexual and reproductive health services by pharmacists, including hormonal contraception and medication abortion. The researchers also assessed the implementation of state policies that enable pharmacists to prescribe PrEP, PEP, hormonal contraception, and emergency contraception.

Results show that three years after the implementation of California’s Senate Bill (SB) 159 permitted pharmacists to prescribe oral pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP), only 11% of the pharmacists surveyed reported that their pharmacy offered these HIV prevention medications.

Similarly, six years after SB 493 granted pharmacists the ability to prescribe hormonal contraception, only 30% of pharmacists surveyed reported working in a pharmacy where self-administered hormonal contraception (e.g., the pill, the patch, ring, or injection) is available without an outside provider’s prescription.

“The results of our study provide strong support for the untapped potential of pharmacists to facilitate expanded access to essential sexual and reproductive health services across California,” said co-author Laura Packel, Ph.D., a researcher at UC Berkeley’s School of Public Health. “Addressing a handful of implementation barriers, including insurance reimbursement for pharmacy-based service provision, could help California tap their potential.”

The most common barrier pharmacists cited to prescribing HIV prevention medications and contraception was inadequate staff (37%) or time to add new services (42%). A lack of training was also reported. In particular, just 29% of practicing pharmacists said that they had been trained on PrEP and PEP service provision, while one-third (32%) indicated a lack of knowledge or training about hormonal contraception was a barrier.

“It is vital that barriers to the provision of preventative medications be addressed,” said co-author Loriann De Martini, Pharm.D., CEO of the California Society of Health-System Pharmacists. “Expanding training programs—and improving the marketing of existing programs—as well as providing additional reimbursement for services beyond the cost of the medication could help improve access to essential health services.”

“With Roe v. Wade overturned, access not only to abortion but also contraception has been disrupted across the country,” said co-author Cathren Cohen, staff attorney at the Center on Reproductive Health, Law, and Policy at UCLA Law. “Novel approaches are needed to ensure access to reproductive health services and abortion medications, and community pharmacies can be an important source of this care.”

This report was authored by the California HIV/AIDS Policy Research Centers, which includes researchers from the University of California, Berkeley School of Public Health; the Luskin School of Public Affairs, and the University of California, San Francisco School of Nursing. Additional contributors include the Center on Reproductive Health, Law, and Policy at the UCLA School of Law; California Society of Health-System Pharmacists; and Birth Control Pharmacist.

Read the report

XXX

The California HIV/AIDS Policy Research Centers seek to bring the most relevant and timely evidence to bear on HIV policymaking in order to further California’s efforts to develop and maintain efficient, cost-effective, and accessible programs and services for people with or at risk of HIV/AIDS.