title: Pharmacy Intervention to Improve HIV Testing Uptake Using a Comprehensive Health Screening Approach.
abstract: OBJECTIVE
  HIV testing is increasingly available, yet barriers to HIV testing persist for low-income black and Latino people, especially those who use illicit drugs. HIV exceptionalism, or the idea that a positive HIV diagnosis is drastically different from a diagnosis for any other disease, may influence HIV testing-related stigma, resulting in reduced willingness to undergo HIV testing. This pharmacy-based intervention combined HIV testing with less stigmatized chronic disease screening tests (e.g., blood pressure, glucose, and cholesterol) to equate the concept of an HIV diagnosis with other diagnoses.
  
  
  METHODS
  Three pharmacies located in low-income, minority neighborhoods in New York City were enrolled in an intervention to provide (1) HIV testing, chronic disease screening, and a healthy lifestyles video that normalized all screening tests and destigmatized HIV as a fatal disease (comprehensive arm); (2) HIV testing and the video (video arm); and (3) HIV testing only (control arm). Injection drug users (IDUs) and pharmacy staff recruited un- and underinsured pharmacy customers, IDUs, and IDU peers from 2010 to 2012. Participants in the control group were compared with those in the comprehensive and video intervention groups.
  
  
  RESULTS
  Participants in the comprehensive arm (prevalence ratio [PR] = 1.61, 95% confidence interval [CI] 1.03, 2.49, p=0.08) and the video arm (PR=1.59, 95% CI 1.00, 2.53, p=0.09) were marginally significantly more likely to receive an HIV test in the pharmacy compared with those in the control arm after adjustment.
  
  
  CONCLUSIONS
  These findings suggest that adoption of strategies that destigmatize and normalize HIV testing can improve uptake. Implementation of this strategy in low-access, minority communities with high HIV prevalence and among high-risk populations may help reduce racial/ethnic disparities in HIV.
authors: Emory University, Rollins School of Public Health, Behavioral Sciences and Health Education, Atlanta, GA.
authors: Natalie D
authors: ND
authors: Crawford
authors: Jaeb Center for Health Research, Tampa, FL.
authors: Trevano
authors: T
authors: Dean
authors: Columbia University, Mailman School of Public Health, Department of Epidemiology, New York, NY.
authors: Alexis V
authors: AV
authors: Rivera
authors: Emory University, Rollins School of Public Health, Behavioral Sciences and Health Education, Atlanta, GA.
authors: Taylor
authors: T
authors: Guffey
authors: Columbia University, Mailman School of Public Health, Department of Population and Family Health, New York, NY; Columbia University, College of Physicians and Surgeons, Center for Family and Community Medicine, New York, NY.
authors: Silvia
authors: S
authors: Amesty
authors: The Calverton Center, Pacific Institute for Research and Evaluation, Calverton, MD.
authors: Abby
authors: A
authors: Rudolph
authors: Columbia University, Mailman School of Public Health, Department of Epidemiology, New York, NY.
authors: Jennifer
authors: J
authors: DeCuir
authors: Nathan Kline Institute for Psychiatric Research, Division of Social Solutions and Services Research, Orangeburg, NY; New York University, School of Medicine, Department of Psychiatry, New York, NY.
authors: Crystal M
authors: CM
authors: Fuller
mesh_terms: D015492:AIDS Serodiagnosis / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009519:New York City; D010342:Patient Acceptance of Health Care; D010353:Patient Education as Topic; D010594:Pharmacies / Q000458:organization & administration*; D012725:Sexual Behavior; D012959:Socioeconomic Factors