Availability and accessibility of HIV self-tests and self-sample kits at community pharmacies in the Netherlands

Chaima Kandil; Jacqueline Hugtenburg; Titia Heijman; Hanna Bos; Martina Teichert; Renee Finkenflügel; Eline Op de Coul

doi:10.1186/s12981-023-00529-9

Availability and accessibility of HIV self-tests and self-sample kits at community pharmacies in the Netherlands

AIDS Res Ther. 2023 Jun 22;20(1):39. doi: 10.1186/s12981-023-00529-9.

Authors

Chaima Kandil¹, Jacqueline Hugtenburg², Titia Heijman³, Hanna Bos⁴, Martina Teichert^{5

6}, Renee Finkenflügel⁷, Eline Op de Coul⁸

Affiliations

¹ National Institute for Public Health and the Environment, Center for Infectious Disease Control, P.O. Box 1, Bilthoven, 3720 BA, the Netherlands.
² Amsterdam University Medical Center, Location VUMC, Amsterdam, the Netherlands.
³ Public Health Service of Amsterdam, Amsterdam, the Netherlands.
⁴ STI Aids Netherlands, Amsterdam, the Netherlands.
⁵ Royal Dutch Pharmacists Association (KNMP), the Hague, the Netherlands.
⁶ Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands.
⁷ Dutch Association of People with HIV (the HIV vereniging), Amsterdam, the Netherlands.
⁸ National Institute for Public Health and the Environment, Center for Infectious Disease Control, P.O. Box 1, Bilthoven, 3720 BA, the Netherlands. Eline.op.de.coul@rivm.nl.

Abstract

Background: In 2016 the WHO declared HIV self-testing and self-sampling an effective and safe test option that can reduce testing barriers. HIV self-tests and self-sampling kits (HIVST/HIVSS) are available for purchase at Dutch community pharmacies since 2019. We investigated the availability and accessibility of HIVST/HIVSS in community pharmacies, and factors associated with test availability.

Methods: An online survey among all Dutch community pharmacies (n = 1,987) was conducted between April and June 2021. Availability of HIVST/HIVSS and experiences of pharmacists with the test offer were analyzed with descriptive statistics. The association of pharmacy and pharmacists' characteristics with HIVST/HIVSS availability was explored by logistic regression analysis.

Results: In total, 465 pharmacists completed the questionnaire. Of the responding pharmacists, 6.2% (n = 29) offered HIVST/HIVSS. The majority (82.8%) sold between 0 and 20 tests per year. In total, pharmacies sold an estimated 370 HIVST/HIVSS per year. Pharmacies having HIVST/HIVSS available were less often located in moderately-urbanized to rural neighborhoods (OR 0.35, 95%CI 0.16-0.77 versus highly-urbanized), and were less often located in moderate-to-low SES neighborhoods (OR 0.40, 95%CI 0.18-0.88 versus high-SES). Reasons for not offering HIVST/HIVSS by pharmacists were no or little demand (69.3%), and not being familiar with these tests (17.4%). 52% of the pharmacists provided information about testing to test buyers. Reported options to improve the test offer were giving advice about (performing) the test to test buyers (72.4%), placing tests visible on the counter (51.7%), and advertisement (37.9%).

Conclusion: HIVST/HIVSS have a limited practical availability in Dutch community pharmacies since their introduction in 2019, especially in lower-urbanized and lower-SES areas. Further research is needed to explore how to expand access to HIVST/HIVSS through community pharmacies in the Netherlands, and how to tailor it to the needs of pharmacy clients.

Keywords: HIV self-sampling; HIV self-tests; HIV testing; Home testing; Pharmacies.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

HIV Infections* / diagnosis
HIV Infections* / epidemiology
HIV Testing
Humans
Mass Screening
Netherlands
Pharmacies*