Table 4.
Predictors of pharmacist PrEP dispensing and comfort counseling patients about PrEP, Indiana 2016 (N = 284)
| Variable | PrEP dispensing |
Comfort counseling about PrEP |
||||||
|---|---|---|---|---|---|---|---|---|
| Parameter estimate | Risk ratio | 95% CI | Parameter Estimate | Risk ratio | 95% CI | |||
| Knowledge and knowledge confidence | ||||||||
| Aware of PrEP prior to the survey | 0.767 | 2.15 | 1.01 | 4.60 | −0.060 | 0.94 | 0.74 | 1.20 |
| Confident in knowledge about PrEP aspects | ||||||||
| Medication adherence | 1.024 | 2.78 | 1.36 | 5.70 | 0.543 | 1.72 | 1.23 | 2.41 |
| Medication adverse effects | −0.271 | 0.76 | 0.43 | 1.36 | 0.023 | 1.02 | 0.81 | 1.30 |
| Behavior modification, such as condom use | −0.510 | 0.60 | 0.32 | 1.12 | 0.098 | 1.10 | 0.87 | 1.41 |
| Pharmacist practice | ||||||||
| You or other pharmacists have consulted a patient/customer about PrEP | −0.116 | 0.89 | 0.68 | 1.16 | ||||
| Pharmacy and pharmacist characteristics | ||||||||
| Number of full time pharmacists | 0.183 | 1.20 | 1.05 | 1.37 | 0.033 | 1.03 | 0.96 | 1.11 |
| Pharmacy located in a metropolitan area | 0.520 | 1.68 | 0.47 | 6.05 | ||||
| HIV certified pharmacist | 0.351 | 1.42 | 0.74 | 2.73 | ||||
| Continuing education in the past 2 years | ||||||||
| HIV management | −0.106 | 0.90 | 0.48 | 1.67 | 0.098 | 1.10 | 0.91 | 1.34 |
| PrEP (Pre-exposure prophylaxis for HIV prevention) | −0.183 | 0.83 | 0.39 | 1.79 | 0.171 | 1.19 | 0.92 | 1.53 |
| Pharmacist comfort, beliefs, and attitudes | ||||||||
| Pharmacists can be an important resource for HIV and HCV treatment (Strongly Agree) | 0.041 | 1.04 | 0.58 | 1.89 | 0.297 | 1.35 | 1.03 | 1.75 |
| Comfortable dispensing PrEP to anyone who has a medical need and a prescription | 0.820 | 2.27 | 0.58 | 8.95 | ||||
| Potential barriers to PrEP dispensing | ||||||||
| None | −0.025 | 0.98 | 0.81 | 1.17 | ||||
| Only HIV-specialty pharmacists should counsel patients about PrEP | −0.560 | 0.57 | 0.14 | 2.41 | −0.715 | 0.49 | 0.26 | 0.91 |
| Personal discomfort counseling a patient about sexual activity in general | 0.184 | 1.20 | 0.75 | 1.93 | ||||
| Use of PrEP would reinforce risky sexual or injection behaviors | −1.482 | 0.23 | 0.05 | 1.01 | ||||
| Personal discomfort counseling a patient about gay sexual activity | −0.738 | 0.48 | 0.24 | 0.93 | ||||
| Personal disagreement with dispensing PrEP because I don’t agree with the lifestyle choices that this drug enables | −0.839 | 0.43 | 0.18 | 1.02 | ||||
| Community characteristics | ||||||||
| Have been asked in the past 2 years about | ||||||||
| PrEP by customers, medical providers or other pharmacists | 0.081 | 1.08 | 0.54 | 2.17 | −0.071 | 0.93 | 0.72 | 1.20 |
| PEP (Post exposure prophylaxis) by customers, medical providers or other pharmacists | 0.179 | 1.20 | 0.61 | 2.35 | 0.013 | 1.01 | 0.79 | 1.30 |
| HIV antiretroviral treatment by customers, medical providers or other pharmacists | 0.335 | 1.40 | 0.80 | 2.43 | 0.241 | 1.27 | 1.03 | 1.57 |
| Difference in new HIV cases from 2015 to 2016 in the county | 0.022 | 1.02 | 0.998 | 1.05 | 0.003 | 1.00 | 0.99 | 1.01 |
| Number of people per primary care physician (county health rankings), 2017 | −0.0004 | 1.00 | 0.999 | 1.00 | ||||