title: Community Pharmacy Use Patterns of Women with HIV and Women At Risk for HIV in the San Francisco Bay Area.
abstract: BACKGROUND
  Community pharmacies play a key role in the care of patients when dispensing antiretroviral therapy. The primary objective of this study was to describe patterns of community pharmacy use of women enrolled in the San Francisco site of the Women's Interagency HIV Study (WIHS). The secondary objective was to determine whether the number of pharmacies a patient uses is associated with specific patient characteristics or virologic outcomes in HIV positive women.
  
  
  OBJECTIVE
  The primary objective was to determine factors which were associated with using multiple dispensing pharmacies to obtain medications in a population of HIV+ and at-risk women. The secondary objective was to determine whether use of multiple pharmacies was associated with immunologic or virologic changes for the subset of HIV+ women.
  
  
  METHODS
  A survey on community pharmacy use was distributed to San Francisco WIHS participants from 2004-2007. Poisson, linear, and logistic regression methods were used to determine associations between specific patient characteristics and use of multiple dispensing pharmacies and associations between multiple pharmacy use and CD4+ cell count or viral load changes.
  
  
  RESULTS
  There was a trend towards an association between HIV status and use of multiple pharmacies (IRR=1.23; 95% CI 1.00-1.51, p =0.05). In multivariable analyses of HIV positive women, use of additional pharmacies (over the primary pharmacy) during the study period was not associated with statistically significant changes in CD4+ count or viral load.
  
  
  CONCLUSIONS
  HIV positive participants may tend to use multiple pharmacies more frequently than their HIV negative counterparts, though this practice does not appear to be associated with poorer immunologic or virologic outcomes. Future studies should be conducted to determine whether different patient patterns of community pharmacy use affect HIV treatment outcomes.
authors.affiliation: Department of Clinical Pharmacy, University of California, San Francisco School of Pharmacy, 521 Parnassus Avenue, C-152, Box 0622, San Francisco, CA 94143, Telephone: (415) 514-0892, , cocohobaj@pharmacy.ucsf.edu.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Cocohoba
authors.affiliation: Department of Pharmacy, San Francisco Veterans Affairs Medical Center.
authors.forename: Tracy
authors.initials: T
authors.lastname: Hsu
authors.affiliation: Medicine, Epidemiology and Biostatistics, and Clinical Pharmacy, University of California, San Francisco Schools of Medicine & Pharmacy.
authors.forename: Ruth M
authors.initials: RM
authors.lastname: Greenblatt
keywords: HIV; community pharmacy; women