Introduction
More than 40 years have passed since Canada’s first reported case of HIV in 1981. As HIV treatment has evolved, so too has the role of the pharmacist in caring for people with HIV. What was once a terminal diagnosis has become a chronic condition with limited impact on life expectancy when managed with contemporary antiretroviral therapy (ART).1–3 Although people with HIV are at increased risk of developing age-related comorbidities compared with people without HIV,2,4,5 they are now hospitalized less frequently for HIV-related complications.6,7 As such, HIV is often managed in outpatient settings.8 Reflecting on the advances in therapy and changing demographics of this patient population, pharmacists in community and long-term care settings are increasingly caring for people with HIV in their practices.
While the general principles of ART have not changed since the last Canadian publication on the pharmacist’s role in caring for people with HIV,9 many therapeutic advances have occurred, including options for biomedical HIV prevention and development of long-acting ART. Although many pharmacists have not received comprehensive HIV training, pharmacists are expected to recognize and distinguish between ART for HIV prevention and treatment and to provide person-centred care to individuals on ART, regardless of indication or practice setting.
The HIV cascade of care, a framework used to benchmark progress in HIV management efforts, describes the trajectory from HIV diagnosis to viral suppression,10–15 and similar cascades exist for HIV prevention.16–19 Pharmacists have roles throughout the continuum of HIV prevention and care (Figure 1), underscoring the many ways pharmacists contribute to individual- and population-level HIV prevention and management. This article focuses on the role of the pharmacist within the cascade, serving as a practical guide to new pharmacists providing HIV care, pharmacy students, residents, and community or hospital pharmacists with limited HIV experience. HIV-specific resources are included that further elaborate on concepts discussed in this article, and a list of common terms and abbreviations is included in Appendix 1 in the Supplementary Materials, available in the online version of the article.
