David Rosario remembers the late 1980s with mixed emotions. He had achieved his goal of becoming a professional dancer in New York City, but in that world he also lost many young male friends to AIDS. There were few treatment options available then for the disease that hit the gay community especially hard.
“It was sad at that time,” Rosario said. “There was nothing there, so these beautiful people lost their lives.”
Now, Rosario owns a restaurant in New Jersey with his husband. Every month, he picks up medication at his local Walmart pharmacy that makes HIV undetectable and untransmittable — a prospect that was unthinkable just a generation ago. But that ease of access now gives him hope.
“It’s not a big, terribly big deal for me, but for a lot of these young boys that are searching for relationships and things, I think it is a game-changer,” he said.
Walmart’s HIV outreach
The Centers for Disease Control and Prevention estimates new HIV infections have fallen 12% in recent years, from 36,500 new cases in 2017 to 32,000 in 2021. Yet racial and ethnic disparities remain pronounced, with people of color accounting for a disproportionate share of new HIV diagnoses. African Americans accounted for 40% of new cases in 2021, and Latinos accounted for 29%, according to CDC data.
Walmart launched an HIV specialty-pharmacy pilot program in late 2021, targeting just over half a dozen highly affected communities, including Rosario’s county in New Jersey.
“We can see from the data that that there’s a need here — there’s a higher incidence of HIV,” said Kevin Host, Walmart pharmacy senior vice president.
Now, the retail giant plans to expand its program to more than 80 HIV-specialty facilities across nearly a dozen states by the end of this year.
The company’s pharmacists have undergone specialized training on HIV conditions and drugs to treat and prevent the virus. A big part of that is how to begin a conversation with patients who might be at risk.
“Getting patients to talk about their status can be a challenge,” said pharmacist Gemima Kleine. “There’s the stigma around it, and it’s better than it used to be, but it’s not gone.”
Public-private HIV partnership
That stigma may contribute to people in some communities being reluctant to seek treatment. But it’s not the only problem people who might be HIV positive face.
Last year, while just over half of non-Hispanic white patients had coverage for pre-exposure prophylaxis medications, known as PrEP, CDC data shows just 13.6% of Latino and 6.9% of African American patients were covered for the drugs, which help prevent transmission of the virus.
To help fill the gap, Walmart and two of its large pharmacy rivals, CVS Health and Walgreens, have signed on to the Department of Health and Human Services’ initiative to end the HIV epidemic by 2030 by making antiviral medications more widely available and providing support services.
“There are certain medications where maybe if you miss a dose, it’s not the worst thing, you won’t have that much of an impact, but with the HIV AIDS medications, that compliance is so important,” Kleine said.
CVS has made HIV testing available at its Minute Clinics and helped patients access prescriptions with no out-of-pocket costs through the government program known as Ready, Set, PrEP.
Similarly, Walgreens has trained more than 3,000 of its pharmacists to offer treatment advice, provide ongoing testing and facilitate free home delivery of HIV meds to help encourage patients to adhere to medication regimens.
And Walmart has seen its outreach — to local health clinics and community groups that help patients gain medical coverage in highly affected communities — begin to pay off.
“When they know that we’ve got additional training and services to help their patients, we’ll start to see them come in, and that’s when we get to engage with them,” Host said. “It’s really been a great marriage between community and business.”
On June 27, as part of National HIV Testing Day, Walmart will also join other pharmacies and offer free HIV testing across its stores.
The HIV program outreach has come as major pharmacies are focusing on expanding their health-care services. They’re hoping initiatives such as the specialty pharmacies will underscore their role as community retail health providers in consumers’ minds — and improve outcomes for patients.
“Hopefully, they will be rolling something like this out in small towns, cities — that maybe it’s harder to get things or they’re unaware,” Rosario said.