Abstract
Background: Knowledge and competence of community pharmacists in HIV care, are essential for translating the goals of differentiated care into improved outcomes.
 Aims: To assess the knowledge and competence of community pharmacists in Jos, for differentiated HIV care and services.
 Study Design: Cross-sectional questionnaire survey.
 Place and Duration of Study: Community pharmacies in Jos North and Jos South local government areas of Plateau state, North-Central Nigeria, between September to November, 2018.
 Methodology: We included community pharmacists who responded to six items on knowledge of HIV therapeutics with each correct answer recording a score of 1 and zero for wrong answers. Respondents with a correct score of 5 or 6 represent good knowledge. We examined competence on a 36 item scale graded 1 for weak competence and 5 for strong competence. Factor analysis; reduce the 36 scale items down to competency domains. Frequencies and percentages for reported competencies were presented. In addition, aggregated scores for each of the competency domains were used to compare respondents based on years of experience, educational level and employment status in community pharmacy. All levels of significance were set at p≤ 0.05.
 Results: 73 out of 110 community pharmacists responded to the questionnaire. Of these, only 25% reported good level of knowledge in HIV therapeutics. 69% reported strong competency in identifying drug therapy problems, 31% inter-professional and patient communication. There was statistically significant difference in competency domains based on years of practice experience and employment status p<0.05. Respondents with 10 years or less of practice experience recorded higher mean ranked scores compared to those with 11 or more years. Similarly, employed pharmacists recorded higher mean ranked scores than those who owned their business.
 Conclusion: Overall, respondents reported low knowledge and weak competency in HIV care emphasizing the need for specialized training before implementation of differentiated care model.
Highlights
We included community pharmacists who responded to six items on knowledge of human immunodeficiency virus (HIV) therapeutics with each correct answer recording a score of 1 and zero for wrong answers
Remarkable success recorded in the prevention and treatment of infection with the human immunodeficiency virus (HIV) over the last two decades, is expected to be consolidated with the achievement of the UNAIDS 90-90-90 targets of diagnosing 90% of all HIV-positive persons, providing antiretroviral therapy (ART) for 90% of those diagnosed and achieving viral suppression for 90% of those treated by the year 2020; as an essential step towards ending the HIV/AIDS pandemic by the year 2030 [1,2]
The community pharmacy setting offers a ready structure for this innovative model of care by simplifying processes of obtaining antiretroviral drugs (ARVs) in a friendly and discrete environment especially because they open long into the evenings, weekends and holidays, which guarantee wide spread access for the local population unlike services offered in public hospitals
Summary
Remarkable success recorded in the prevention and treatment of infection with the human immunodeficiency virus (HIV) over the last two decades, is expected to be consolidated with the achievement of the UNAIDS 90-90-90 targets of diagnosing 90% of all HIV-positive persons, providing antiretroviral therapy (ART) for 90% of those diagnosed and achieving viral suppression for 90% of those treated by the year 2020; as an essential step towards ending the HIV/AIDS pandemic by the year 2030 [1,2]. Laudable as the 90-90-90 targets may be, it is believed that achievement of the goals of this strategy would significantly weaken health systems and impede the fight against the rising burden of noncommunicable diseases (NCDs) in low-income countries (LICs) [3] This underscores the imperatives of adopting community based models of HIV care and support services to enhance screening and treatment of new patients, as well as the early identification of patients lost to follow-up in a bit to retain more on treatment and improve overall clinical outcomes [4]. Community based models of care for stable patients living with HIV adopt the principles of decentralization and task shifting designed to deliver antiretroviral therapy (ART) efficiently and encourage long-term retention of patients [5] This model otherwise known as differentiated care for HIV reduces the extra burden on the overstretched workforce in the health systems of developing countries like Nigeria [6].
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