The implementation of a pharmacist-led testing service for HIV and hepatitis C in rural Newfoundland and Labrador correctional facilities: a pilot study

Human Immunodeficiency Virus (HIV) and hepatitis C virus (HCV) disproportionately affect people who are incarcerated, yet access to testing remains limited. Point-of-care (POC) testing may overcome barriers associated with venipuncture, but acceptability and feasibility must be established. This pilot study assessed pharmacist-led HIV and HCV testing in three rural correctional facilities in Newfoundland and Labrador (NL). Using a prospective interventional cohort design, incarcerated adults were offered pharmacist-administered POC tests, pre- and post-test counseling, and linkage to confirmatory testing as needed. Participants completed surveys on demographics, risk behaviours, and acceptability. Correctional staff provided feedback through post-visit interviews. Of 102 incarcerated individuals, 75 volunteered for testing through this study, completing 73 HIV and 58 HCV tests. Six HCV reactive results and no HIV reactive results were identified; confirmatory testing detected four new HCV infections. Nearly half of participants (46%) had never been tested previously and curiosity regarding infection status was the primary motivation (73%). Acceptability was high, with nearly all participants reporting comfort with pharmacist-led testing and an absence of stigma. Pharmacist-led HIV and HCV POCT appears feasible and highly acceptable in correctional facilities. Findings support expanding testing access through pharmacists in corrections to improve early detection and linkage to care.