"This epidemic in the U.S. is the face of the forgotten people," said Del Rio, who added that most HIV-positive people are low-income with little education and access to care. "The disease is alive and well in certain areas, and community-based organizations are going to be key in bridging the gap in care."
The researchers chose five different community pharmacies in hot spot areas that have heavy foot traffic. Public Health Advocates, or PHAs, were trained to approach people in the pharmacies and on the sidewalks to offer HIV testing. When an individual agreed to getting tested, the PHA would administer the rapid HIV test, which consisted of a simple swab of saliva, which provided initial results in 20 minutes.
If and when people received a positive diagnosis at the pharmacy, the PHAs offered to immediately bring the patient to a local HIV clinic, bridging the gap in an initial diagnosis and preliminary HIV treatment and care.
Study authors said the results of participation show that local pharmacies in HIV hot spots not only may help in getting more people tested, but may also be able to bridge the gap in care once a diagnosis is received. They also hope to destigmatize HIV testing as much as possible by bundling the test with other screenings (like Hepatitis C) and eventually make the test as accessible as getting a flu shot.
"We really want to reduce stigma and make it less scary than just getting tested for HIV alone," said Dr. Yvette Calderon, professor of clinical emergency medicine at Albert Einstein College of Medicine and lead author of the study.
The researchers are currently conducting another similar study with a new cohort of patients.
"Imagine this kind of grassroots things about any sort of health issue, where people can learn to empower themselves and be their own advocate," said Sabrina Heard, an HIV community outreach worker with the Women's Collective. "That, combined with compassion, is going to be what makes a difference."
This story is the first of Mikaela Conley's four-part series on HIV Hot Spots in America. Her reporting was supported by the California Endowment Health Journalism Fellowships, a program of the University of Southern California's Annenberg School of Journalism.