I find myself challenged and intrigued by my work as an HIV pharmacist. My work is varied, and no two days are the same. 

I work as part of a team comprising two medical consultants, specialist nurses, lead blood-borne viral pharmacist, and support staff who are invaluable to the team.

My main remit is medication reviews of our patients, especially since the cohort of HIV patients has changed over the years — with more than 60% above 50 years and with the associated co-morbidities that go along with growing old.

What my typical day as an HIV pharmacist looks like:

My typical clinic day starts with a medication review of patients after the nurses have seen them for their routine blood, weight, and other requested monitoring. I confirm their compliance and discuss any coping mechanisms with their medications.

Medication reviews always bring up twists and turns. For instance, what advice do you give to a patient traveling across different time zones about when to take their medication? 

Many patients do not see herbal preparations and local treatments (e.g., steroids cream) as ‘proper medications.’ However, due to numerous interactions with HIV medications (especially protease inhibitor-based), I have to approach each consultation in a way that covers all these so that I can have an accurate picture and advise as appropriate.

Pharmacy input is also vital, especially regarding medication switches due to patients’ clinical issues, e.g., cirrhotic patients, patients with cardiovascular diseases, or mental health issues. 

Patients have a minimum bi-annual review of their care. An algorithm used in the clinic written by a consultant based on BHIVA guidelines on monitoring HIV-positive patients is followed. I tend to use that if I am doing a review beyond only medications, and I have my consultants nearby if I need to clarify some issues during the review. We also have end of clinic discussions of patients seen and patients to be seen the following week.

Aside from weekly clinics, I get referrals from colleagues when HIV+ patients are admitted in the hospital for advice and monitoring if there are any issues — e.g., swallowing difficulties, pre or post-surgery, and interaction with newly started medications. 

That is where my qualification as a prescribing pharmacist comes in handy, since I can prescribe any missed HIV medications and educate staff about the risk of developing resistance due to missed doses.

One of the favourite parts of my role is educating other healthcare professionals on the current management of HIV and how the prognosis has improved dramatically over the years. For instance, HIV+ patients have better life expectancy than other well-known diseases, e.g., Type 2 Diabetes Mellitus. 

I use every opportunity to inform patients and healthcare professionals of the advancement in HIV treatment and help to reduce the stigma associated with the disease.