Title: PEOPLE LIVING WITH HIV/AIDSIN EGYPT: ROLE OF COMMUNITY PHARMACIST Authors :

1. Title: PEOPLE LIVING WITH HIV/AIDSIN EGYPT: ROLE OF COMMUNITY PHARMACIST Authors: Nahla Maher Hegab Pharmacy graduate. Institution: College of pharmacy, University of Alexandria Abstract Problem Statement: All people living with HIV should have a core set of interventions to prevent opportunistic infections, maximize their health, prevent further HIV transmission and in some cases, delay the progression of the HIV disease. In Egypt people living with HIV receives the proper medication according to the national HIV/AIDS guidelines. Although the prevalence of HIV/AIDS in Egypt is low but there is limited access to information on those at most risk and refuse to seek access to health services due to discrimination, social marginalization and unfavorable legalization. Objectives: To identify the role of community pharmacists to encourage suspected HIV/AIDS patients to seek health care service available at the national HIV/AIDS programme. Design: A questionnaire was designed pharmacists to evaluate the knowledge of community pharmacists in Alexandria about HIV/AIDS, availability of medication and the national guidelines to proper access to medication. Study population: 100 community pharmacists in Alexandria governorate were randomly selected to participate in the study.

2. Abstract Policy: The questionnaire is a primary evaluation of community phamacists’ knowledge about HIV/AID, national guidelines, antiretroviral drugs, patient counseling and whether they are willing to join the national campaign to encourage people living with HIV/AIDS to seek medication within the national programme. Outcomes: Community pharmacists are potentially useful resource. Results: It was found that 80% of community pharmacists know the definition of HIV/ AIDS, 70% of them doesn't know the available anti retroviral drugs and that the medication is available at the national HIV/AIDS programme. 100 % of them never dealt with an HIV/AIDS patient. Only 65% of community pharmacists are willing to participate in the national campaign to encourage people living with HIV to seek medication within the national program in public sector hospitals in ministry of health. Conclusion: Community pharmacists are potential partners that can be deployed highly effectively and they can play a key role in controlling HIV/AIDS in Egypt. It is important to provide them with appropriate knowledge about the disease, social aspects, treatment guidelines, and bridging the gap between sexual and reproductive health and HIV. The contribution of community pharmacist can improve the number of people seeking access to proper medication at the national HIV/AIDS programme working at certain health facilities.

3. Introduction All the people living with HIV should have a core of interventions to prevent opportunistic infections, maximize their health, prevent future HIV transmission and in some cases delay progression of the disease. In Egypt the national HIV/AIDS programme has adopted the new WHO guidelines of early diagnosis and treatment. In Egypt the challenge we face is the low percentage of people seeking medication and counseling are few. They fear stigma and discrimination. The available data from http://www.emro.who.int/asd/hivsituation_countryprofiles.htm showed that the estimated number of people needing ART, based on UNAIDS /WHO methodology is 2,200. And the total Number of adults and children with advanced HIV infection who are currently receiving ART is 301. In the mean time the role of pharmacist in the healthcare team was studied by the WHO, FIP and several national and regional associations. There was clear consensus that pharmacists particularly community pharmacists should have significant role in promoting health programmes.

4. Introduction Good pharmacy practice involves four main groups of activities: • Activities associated with promotion of good health, the avoidance of ill-health and the achievement of health objectives. • Activities associated with the supply and use of medicines and of items for the administration of medicines or for other aspects of treatment (these activities may be undertaken in the pharmacy, in an institution or in a home-care setting. • Activities associated with self-care, including advice about and, where appropriate, the supply of a medicine or other treatment for symptoms that lend themselves to self-treatment • Activities associated with influencing the prescribing and use of medicine. • No reports were found on the role of pharmacists particularly community pharmacists in support o people living with HIV /AIDS. We believe that pharmacists can play an important role on encouraging suspected AIDS patients to seek advice of the national AIDS programme.

5. Objective The purpose of this study was to evaluate the community pharmacists' knowledge about HIV/AIDS, national guideline, antiretroviral drugs, patient counseling and whether they are willing to participate in the national campaign to encourage people living with HIV/AIDS to seek medication within the national programme.

6. Methods A questionnaire was designed to evaluate community pharmacists' knowledge about HIV/AIDS, national guidelines; anti-retroviral drugs and whether they are willing to participate in the national campaign to encourage people living with HIV/AIDS to seek medication within the national programme. 100 Community pharmacists in Alexandria were randomly selected to participate in this study. The participating pharmacists are either community pharmacist owner or pharmacists working in private sector pharmacies. Figure 1: percentage of pharmacy owners & pharmacists working in community pharmacies:

7. Methods The questionnaire used in the study: Name (optional): Age: 1. Where does u work? Private pharmacy Public pharmacy 2. Do you know HIV virus? Yes No 3. Do you know what AIDS is? Yes No 4. Do you think that HIV is transmitted more among homosexuals and drug addicts? Yes No 5. Do you know how quickly does the patient infected with HIV develop AIDS? Yes No 6. Do you know if there is a cure for HIV? Yes No 7. Do you know what the Anti-retroviral drugs are? Yes No 8. Do you know that Anti-retroviral drugs are available in the HIV/AIDS National programme? Yes No 9. Have you ever dealt with people living with HIV/AIDS? Yes No 10. Do you know the recent approaches to HIV prevention and treatment? Yes No 11. Do you think community pharmacists as health care providers need more education about epidemic diseases like AIDS , Hepatitis C, etc.? Yes No 12. Do you think community pharmacists can be considered to have a role in an awareness campaign about AIDS? Yes No 13. Are you willing to participate in the national campaign to encourage people living with HIV/AIDS and others at risk to seek medication within the national programme? Yes No If yes,How? Flyer Posters Patient counseling

8. Results Figure 1: Shows that 80%of community pharmacists know the definition of HIV /AIDS

9. Results Figure 2: Shows that 70% of community pharmacists don’t know Anti-retroviral drugs and that medication is available in the national HIV/AID programme.

10. Results The results also showed that 100% have never dealt with any HIV/AIDS patients .The fact that 20% don’t know the definition of HIV/AIDS and 70% of community pharmacists don’t know Anti-retroviral drugs and that the medication is available in the national HIV/AIDS programmeand no community pharmacist has dealt with people living with HIV/AIDS clearly shows that pharmacists should improve their knowledge and professional practice in this area .

11. Results Figure 3: Shows that Only 65% of community pharmacists are willing to participate in the national campaign to encourage people living with HIV/AIDS too seek medication within the HIV/AIDS national programme.

12. Results Figure 4: Shows that 65% of community pharmacists think that they need more education about sexually transmitted diseases like HIV/AIDS and epidemic diseases like Hepatitis C to be able counsel patients and people at risk. Last but not least the community pharmacists are willing to participate in the national HIV/AIDS campaign to increase percentage of people living with HIV/AIDS to seek medication and to encourage those at risk for early diagnosis and treatment by hanging posters in their pharmacies, distributing flyers to educate people about HIV/AIDS.

13. Summary The low percentage of HIV/AIDS patients seeking treatment in Egypt has raised concern among health professionals .Contribution of pharmacist to increase public awareness and enlarge suspected HIV/AIDS patients to seek advice and treatment at the Egyptian national contrail of HIV/AIDS programme health facilities can make significant improvements .The results obtained in this study showed that there is serious weakness among community pharmacist related knowledge of HIV/AIDS disease and Anti-retroviral drugs. 65% of community pharmacists expressed willingness to programme to encourage people living with HIV/AIDS to seek medication. This is a low percentage. Community pharmacists should be encouraged to carry out one of the main activities of the pharmacy profession namely, Activities associated with promotionof good health, the avoidance of ill-health and the achievement of health objectives. Pharmacy schools should revise the undergraduate curriculum to include this important activity as an integral part of pharmacy profession. Pharmacist's societies should organize contemned education programme to provide community pharmacists with the necessary knowledge and skills to effectively carry out the public health role of community pharmacy profession.

14. Conclusion Community pharmacists are potential partners that can be deployed highly effectively and they can play a key role in controlling HIV/AIDS in Egypt. It is important to provide them with appropriate knowledge about the disease, social aspects, treatment guidelines, and bridging the gap between sexual and reproductive health and HIV. The contribution of community pharmacist can improve the number of people seeking access to proper medication at the national HIV/AIDS programme working at certain health facilities.