By Nikole Trainor, MPH, MCHES, Maria Lopez, Pharm.D., AAHIVP & Stephanie Cohen, MD, MPH
Mission Wellness Pharmacy in San Francisco became the first pharmacy in California to provide PrEP directly to consumers, without the need for a doctor’s prescription. In collaboration with the San Francisco Department of Public Health (SFDPH), and with support from the Getting to Zero consortium, Mission Wellness Pharmacy launched a new pharmacist-delivered PrEP program on Tuesday April 17th, 2018.
The implementation of this innovative One Stop PrEP program involved a lengthy process of writing a Collaborative Practice Agreement (CPA) between SFDPH and Mission Wellness Pharmacy, establishing multiple laboratory contracts, material development, and renovating the historical pharmacy building to include 3 exams rooms. Pharmacy staff were also required to undergo intensive clinical training which included, protocol training, phlebotomy (HIV and HEP C rapid testing) certification, throat swabs procedures, HIV/STD 101 education, obtaining sexual/ medical history and how to provide client-center counseling.
We anticipate that this program will improve access to PrEP (Truvada) for the Latino community and reduce HIV disparities among communities of color in San Francisco. Since the official launch, Mission Wellness Pharmacy has enrolled 5 PrEP participants.
In San Francisco, PrEP is key to the effort to reach zero new HIV infections. Latino men in San Francisco have a new HIV diagnosis rate of 77 per 100,000 population, down from 85 in 2015. From 2014 to 2016, the number of men who have sex with men on PrEP in San Francisco grew from approximately 4,400 to 12,600. The problem of racial and ethnic disparities in PrEP uptake has been slowly improving. In 2014, less than 10 percent of African American, Latino and Asian men who have sex with men who were eligible for PrEP had taken it. That rate increased by 2016 to 31 percent for African Americans, 36 percent for Latinos, 37 percent for Asians. By comparison, more than 43 percent of eligible white men take PrEP.
“One Stop PrEP at Mission Wellness” will address the disparity in PrEP awareness and uptake by providing culturally sensitive one-stop access to PrEP and STD testing services. Currently, people who would like to start taking PrEP, need to schedule an appointment with a physician for required labs and a prescription, which can create a barrier for some individuals. At Mission Wellness Pharmacy, clients will have access to free HIV and STD testing. If medically eligible for PrEP, clients can also receive same-day PrEP on site without ever having to see a physician.