Pharmacists Listen to HIV Positive Women

Pharmacists Listen to HIV Positive Women – Innovative Partnerships to Access Treatment, Information and Support.
In the first of a series of discussions between members of the Commonwealth Pharmaceutical Association (CPA) and ICW, pharmacists listened as HIV positive women spoke of their experiences living as HIV positive members of their communities. Pharmacists asked how they could facilitate treatment, care and support for HIV positive women and their families.

CPA members, professional associations of pharmacists in over 40 Commonwealth countries, initiated the dialogue in response to the UNAIDS theme for 2004 “Women, Girls, HIV and AIDS – Have you heard me today?”

ICW, an international network run by and for HIV positive women in over 100 countries, was keen to contribute to research aimed at exploring innovative ways to increase awareness of HIV transmission and to more effectively provide treatment and support at community level.

A summation of this recent dialogue follows.

“I just want to live without a heavy secret”

The critical need for being in control of who knows their HIV status, and when, was the overwhelming sentiment expressed by many ICW members: to protect their children from stigma and discrimination should their own HIV status become known, to avoid the judgmental attitudes of work colleagues, health workers, family and friends and to reduce the risk of losing their jobs.

HIV positive women often keep their status most secret from those around them whose support they need most. But accessing information, treatment and support is the right of all members of Society. HIV positive women should be able to do so confidently.

We should think about “attitudes”.

“The disease wasn’t a reality for me ….. how things change”

ICW members spoke about “personalising risk” – a risk assessment tool – to help bring home the message that anyone can contract HIV infection. Everyone faces stresses and strains from time to time – relationship problems, financial problems, over-work, no work, working away from home. These challenging circumstances sometimes make us vulnerable, even when we know how HIV can be contracted. Even loving and trusting our partner may not be a defence against HIV.

Ignorance of how HIV infection can be transmitted and lack of negotiation skills greatly increases the vulnerability of many members of our communities, especially young women.

We should think about “awareness”.

“Be strong, know the facts and think clear”

Social and economic imbalances between men and women greatly influence not only vulnerability to HIV infection but also equitable access to treatment, care, support and information. Given the global distribution of HIV by gender, nearly 50-50, women should make up at least half of all people receiving treatment. But this is far from becoming fact.

HIV positive women are strong, and out of their courage to openly share their own experiences, communities could avoid the devastating social and economic costs they now face. Communities can support these efforts by listening to and involving HIV positive women in policy design as well as implementation.

We should think about “access”.

During this dialogue, members of ICW made many practical suggestions as to how pharmacists could improve access to treatment and be sensitive to the needs and concerns of their HIV positive patients and customers. The three areas for future collaboration are seen to be: addressing attitudes, promoting awareness and improving access.

“HIV/AIDS happens to health workers, too”

One of the most important roles pharmacists could play is in helping to change attitudes – not only in the community but also within the pharmacy profession and within all health-related occupations. HIV/AIDS happens to health workers as much as to people in any other occupation, but they are often the most judgmental. Changing perceptions of the stereotypical person with HIV/AIDS is essential and given their relatively accessible and trusted position within their communities, pharmacists could take the lead.

Pharmacists’ leadership on this issue, could help promote greater understanding, reduce fear and ease the current critical need for confidentiality. If health care professionals treat HIV positive people well, others will too.

We should act on “changing attitudes”.

“Information on HIV/AIDS should be freely available, without having to ask for it”

Antiretroviral medications are only one aspect of therapy. Accurate information presented in a confidential and non-confronting manner, can aid concordance and promote patient confidence. Pharmacies could provide a comprehensive range of consumer-focused information on maintaining good health, good nutrition, hygiene, infection control and information on HIV and sexually transmitted infection (STI) prevention and management; information which any customer can pick up at leisure.

Pharmacists working with community leaders could help dispel myths and spread factual information in ways appropriate for each community group.

We should act on “increasing awareness”.

“Prevention, care, treatment and support are all part of a holistic process”

Integration of prevention, care, treatment and support strategies is essential for effective management of HIV/AIDS, within communities. Equitable access to prevention and treatment programmes by any community member, will help promote on-going support and care from within communities. HIV positive women should be instrumental in designing such programmes. Equitable access would help ease the vital need for confidentiality currently experienced by many HIV positive people.

Community pharmacies could be the focal point for such programmes.

We should act on “ensuring equitable access”.

Further discussions between the two organisations will continue during 2005.

Carolyn Bell – Projects Officer, Commonwealth Pharmaceutical Association
Alice Welbourn – Chair, Board of Trustees, International Community of Women Living with HIV/AIDS