Towards Achieving the 95% Treatment Coverage for Hard-to-Reach Populations Living with HIV and AIDS in Lusaka, Zambia Using Community Retail Pharmacies to Improve Access to Antiretroviral Therapy

Abstract

Objective: The HIV and AIDS epidemic still contributes to high mortality and morbidity in Zambia. Antiretroviral (ART) is the backbone of HIV epidemic control. Current ART delivery models have multiple barriers to access and availability. This study explored the feasibility of implementing ART delivery through private retail community pharmacies in Zambia's urban settings based on key stakeholders' perceptions. Methods: This qualitative study utilized a mix of focus group discussions and key informant interviews. Three focus group discussions were conducted with pharmacists practicing in Zambia. Three key informant interviews were conducted with NGO representatives whose primary work is in HIV and AIDS treatment, testing, and prevention. Two key informant interviews were conducted with government representatives from the Zambia MOH involved in HIV and AIDS treatment, testing, and prevention. Deductive theme generation based on research questions was used to analyze the data collected from key informant interviews and focus group discussions. Results: Implementation of ART delivery through private retail community pharmacies in urban settings in Zambia is feasible. Participant perceptions focused on mechanisms, policies, and considerations that must be addressed to implement ART delivery through private retail community pharmacies successfully. Participants indicated that implementing ART delivery through private retail pharmacies requires funding continuing education for participating pharmacists, capacity building for pharmacy infrastructure, and linkage of ART delivery to other HIV and AIDS services like counseling, dieting and nutrition, and viral load monitoring. Conclusion: This study generated new information on the attitudes and perspectives of stakeholders about implementing ART delivery through private retail community pharmacies in Zambia. Implementing ART distribution in private retail community pharmacies in Zambia is feasible, provided key implementation determinants are addressed. The implementation of ART delivery through private retail community pharmacies will help address challenges associated with Zambia's current ART delivery models and improve ART access and coverage.