Prime Time for HIV Prevention Counseling

Pharmacists can expect to answer patient questions related to HIV more often in the beginning of the week.

An article published in AIDS Care summarized recent findings on weekly patterns related to HIV concerns. The researchers found increased interest in HIV-related information when individuals were seeking a fresh start to the week.

“I could envision that pharmacists might get more questions about HIV testing and access to care services early in the week,” David Holtgrave, PhD, professor and chair of the Department of Health, Behavior, and Society at the Johns Hopkins Bloomberg School of Public Health, told Pharmacy Times.

Dr. Holtgrave and his fellow researchers also found patterns of increased sexual risk behavior on weekends among homosexual men who attend circuit parties, which often involve the use of club drugs. A 2011 study found that among 489 circuit partygoers, 18.2% reported they may have had unprotected sex over the weekend.

Further evidence of this pattern may warrant behavioral intervention just before or during high-risk days, the researchers suggested.

Another finding was patients’ desires for weekend and evening clinic hours—especially on Saturday.

“Several authors cited expanded clinic hours as a critical step to removing barriers to care,” the researchers stated.

They also pointed to evidence of messaging systems deploying medication reminders on Mondays being particularly helpful in addressing adherence to antiretroviral therapy (ART). HIV testing campaigns on Mondays have been successful in several programs, as well, the researchers noted.

“In fact, pharmacists having HIV testing and linking to care information especially available early in the week, and other prevention information such as condom access available later in the week, has the potential for better matching the rhythm of clients’ interest and preference in when to access key information,” Dr. Holtgrave told Pharmacy Times.

These finding may be also useful to mobile health systems aimed at improving adherence, especially because previous research has shown some HIV-infected individuals skip ART on weekends in order to consume alcohol freely, without the worry of toxicity from combining alcohol and medication. In addition, transmission risk may increase on weekends as a result of a lack of adherence and alcohol consumption, which can increase sexual risk behavior.

“If such patterns exist, care providers may be better able to discuss ART adherence strategies with patients, especially in light of weekly alcohol use patterns, and behavioral interventions may be better able to tailor content to common risk times throughout the week,” the researchers concluded.