Provision of syndromic treatment of sexually transmitted infections by community pharmacists: a potentially underutilized HIV prevention strategy.
BACKGROUND
Sexually transmitted infections (STIs) are known risk factors for HIV infection.


OBJECTIVE
The goal of this study was to assess the current and potential future role that community pharmacists in Western Cape, South Africa play in the treatment of STIs.


METHODS
A cross-sectional survey of community pharmacists in the Western Cape region of South Africa. A face-to-face interview that ascertained experience with requests from patients for STI treatment, current STI treatment practices, and willingness to provide syndromic STI treatment was administered to head pharmacists.


RESULTS
Ninety pharmacies were selected and 85 (94%) of the head pharmacists participated; 55 from an urban area and 30 from a rural area. Pharmacists reported a median of 40 urban clients and 25 rural clients who sought STI treatment from community pharmacists. When provided with a hypothetical clinical situation, 13% of urban and 17% of rural pharmacists identified the correct medication for male urethral discharge, 8% of urban pharmacists and none of the rural pharmacists identified correct treatment for genital ulcers, and none of the pharmacists identified the correct medication for vaginal discharge. Fifty-three percent of pharmacists in urban regions and 47% of pharmacists in rural regions expressed willingness to provide syndromic STI treatment. Independent predictors of willingness to provide syndromic treatment were knowledge of the link between HIV transmission and STIs (adjusted odds ratio [OR]: 13.78; 95% CI: 2.69, 70.66), past experience prescribing syndromic STI treatment (OR: 11.1; 95% CI: 1.14, 108.6), and male gender (OR: 4.38; 95% CI: 1.15, 16.7).


CONCLUSIONS
Pharmacists are frequently called upon to provide STI treatment but have limited knowledge of correct treatment recommendations. Training pharmacists to provide syndromic STI treatment may be one strategy to reduce STI morbidity and HIV transmission.
Ward
Kim
K
School of Pharmacy, University of the Western Cape, Cape Town, South Africa. klward@mweb.co.za
Butler
Nadine
N
Mugabo
Pierre
P
Klausner
Jeffrey
J
McFarland
Willi
W
Chen
Sanny
S
Schwarcz
Sandra
S
D003157:Community Pharmacy Services / Q000592:standards / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D005831:Genital Diseases, Female / Q000628:therapy; D005832:Genital Diseases, Male / Q000628:therapy; D015658:HIV Infections / Q000517:prevention & control*; D006801:Humans; D008297:Male; D010595:Pharmacists / Q000592:standards / Q000706:statistics & numerical data*; D012424:Rural Population; D012737:Sex Factors; D012749:Sexually Transmitted Diseases / Q000517:prevention & control / Q000628:therapy*; D012959:Socioeconomic Factors; D013019:South Africa; D014456:Ulcer / Q000628:therapy; D014505:Urban Population; D014522:Urethral Diseases / Q000628:therapy; D019522:Vaginal Discharge / Q000628:therapy