THE ROLE OF PHARMACISTS IN HIV STD PREVENTION - EVALUATION OF AN STD SYNDROMIC MANAGEMENT INTERVENTION IN NEPAL/

Objective: To evaluate the effects of a pilot sexually transmitted dis ease (STD) syndromic case management training for pharmacists in Nepal on STD drug dispensing behavior, HIV/STD prevention communication, an d condom promotion and sales. Methods: Pre- and post-intervention inte rviews with samples of 160 pharmacists were conducted utilizing the si mulated client method to collect data on pharmacists' response to men reporting urethral discharge. In order to assess the long-term effects , a sub-sample of 38 pharmacists trained 7-9 months before the follow- up survey was analysed separately. Results: There were no significant differences in the percentages of pharmacists who suggested taking med ications, dispensed medications, or referred clients to a physician. T he proportion of pharmacists who recommended an injection declined fro m 27% to 14%. Prior to the intervention, only one pharmacist (0.8%) di spensed the correct drugs and regimen for the syndromic treatment of u rethritis. This increased to 45% immediately following the training. I n a sub-sample of pharmacists who were interviewed 7-9 months after th e training, the correct drugs and regimen were dispensed by 26%. The p roportion of pharmacists who recommended to clients to have their sex partners treated increased from 5% to 21%. Although the proportion of pharmacists who suggested condom use increased from 14% to 24%, the pr oportion of pharmacists actually selling a condom or giving advice on HIV testing remained low and unchanged pre- and post-intervention. Ove r one-third of pharmacists mentioned HIV or AIDS in their interactions with clients, compared to 9% prior to the intervention. Conclusions: The findings suggest that STD services provided by pharmacists can be significantly improved through a short-term training intervention, alt hough the improvements are modest and probably time-limited. Intervent ions must be more intensive and combined with regular follow-ups if th ey are to meet their desired goals of improving STD treatment in a pha rmacy setting. (C) 1998 Lippincott Williams & Wilkins.