Auburn University pharmacy practice site addresses health disparities among sexual and gender minorities

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When not providing instruction in the classroom, Auburn University faculty within the Harrison School of Pharmacy’s Department of Pharmacy Practice are providing innovative and meaningful care as practitioners at pharmacies, hospitals and clinics throughout Alabama.

One of those faculty members is Kevin Astle, an assistant clinical professor based out of the school’s campus in Mobile. Astle recently joined the pharmacy practice at the University of South Alabama Family Medicine Clinic, where he is providing care for those in the LGBTQ+ community.

“At the clinic, I provide care to a variety of patients, including diabetes, weight management and managing patients with complex medication regimens,” said Astle. “An area of practice that I have identified as a need for pharmacy intervention is providing pharmacy care for sexual and gender minorities, or SGM.”

One area he has focused particular attention on is HIV testing and therapy, as well as the use of pre-exposure prophylaxis, or PrEP, a medicine highly effective at preventing HIV when taken as prescribed.

“HIV pre-exposure prophylaxis is an area of great need within our clinic and Alabama as a whole,” said Astle. “Alabama has been identified as one of 57 geographic areas within the United States as having the highest number of new HIV diagnoses and as a key intervention area in the ‘Ending the HIV Epidemic’ initiative.”

The overall goal of the initiative is to reduce the number of new HIV infections in the United States by at least 90% by 2030. Key strategies to reach the goal are diagnosis, treatment, prevention and response to HIV outbreaks. Agencies across the U.S. Department of Health and Human Services, including the Centers for Disease Control and Prevention, are behind the initiative.

“As pharmacists, we are positioned to assist with all aspects of this response, and I am particularly interested in addressing the preventative services through providing HIV pre-exposure prophylaxis,” said Astle. “HIV PrEP is a medication that can be taken every day and has been proven to reduce HIV infection by up to 99%. I am collaborating with physicians in my clinic to identify high-risk individuals and to provide collaborative care to initiate therapy and improve retention in care.”

Along with treating patients, Astle is using his experience in the clinic to further the education of Auburn students by developing an elective course for providing health care to the LGBTQ+ community.

“In this elective, we explore the many health disparities among sexual and gender minorities and how pharmacists can intervene to address these health disparities, create an inclusive pharmacy environment regardless of practice setting and to improve health care services for sexual and gender minorities,” he said. “Health disparities among sexual and gender minorities include increased rates of HIV infection and sexually transmitted infections, increased incidence of mental health disorders and suicidal ideation and increased rates of substance use disorders. The objective of the elective is to teach students how to provide affirming care and to identify areas for improvement in pharmacy services.”

Astle’s work is also integrated into his research. He was recently one of just 18 investigators nationwide selected to the American College of Clinical Pharmacy Foundation Mentored Research Investigator Training Program. As part of the program, he is collaborating with Dr. Jenna Pfleeger at University of South Alabama Health and Edward Chou, associate professor in the Harrison School of Pharmacy’s Department of Health Outcomes Research and Policy, to address health disparities among sexual and gender minorities.

The research looks at whether family medicine practitioners collect and document sexual orientation and gender identity data and whether they provide appropriate preventative health services to sexual and gender minorities.

“The overall outcome is to identify areas of practice that could be improved to increase the preventative health services provided to sexual and gender minorities,” said Astle.

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