Community pharmacist perspectives on HIV/AIDS and interventions for injection drug users in Canada

In several countries, community pharmacies play a major role in the provision of HIV prevention services to injection drug users (IDUs). In this study, results from a national Canadian Survey of Community Pharmacies and HIV/AIDS Prevention are used to describe pharmacists' perspectives on HIV/AIDS and services to IDUs, and explore the relationship between personal and organizational characteristics and the level of support for HIV/AIDS prevention initiatives. A mailed questionnaire was directed to a random sample of 2,017 pharmacist owner-managers. The response rate was 84.6%. Results suggest that current services to IDUs primarily are limited to discretionary needle and syringe sales to non-diabetics, with almost three-quarters supportive. Staff safety was an important consideration in the provision of this service (77%), while remuneration was the lowest (27%). Community pharmacists were most comfortable with the provision of counselling, advice and literature (X = 2.6) and environmental and technological interventions (X = 2.4) and least supportive of provision of services as part of a programme (X = 1.6) and legalization of drugs or prescription of methadone (X = 1.9). Female pharmacists were more likely to support preventive measures such as the provision of counselling or advice, and males were more likely to promote legislative change. Pharmacists appear generally willing to expand their services in the fight against HIV/AIDS. However, it is not feasible to expect uniform programmes to be immediately introduced. While organizational, educational and policy changes may facilitate programme development, individual pharmacy and pharmacist discretion remains important.