David Rosario remembers the late 1980s with mixed emotions. He achieved his goal of becoming a professional dancer in New York, but also lost many young male friends in that world to AIDS. At the time, few treatment options were available for the disease, which hit the gay community particularly hard.
“It was sad at the time,” Rosario said. “There was nothing there, so these beautiful people lost their lives.”
Now Rosario owns a restaurant in New Jersey with her husband. Every month, he picks up drugs at his local Walmart pharmacy that make HIV undetectable and non-transmissible—a prospect that was unthinkable a generation ago. But this easy access now gives him hope.
“It’s not a big, freaking big deal for me, but for a lot of these young guys who are looking for relationships and things, I think it’s a game changer,” he said.
Centers for Disease Control and Prevention estimates New HIV infections down 12% in recent years, from 36,500 new cases in 2017 to 32,000 in 2021. Yet racial and ethnic disparities remain stark, 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 high-affected communities, including Rosario County, New Jersey.
“What we’re seeing from the data is that there’s a need — there’s a higher incidence of HIV,” said Kevin Host, Walmart’s senior vice president of pharmacy.
Now, the retail giant plans to expand its program to more than 80 HIV-specialized facilities in nearly a dozen states by the end of this year.
Shoppers wait in line at a Walmart store pharmacy in Charlotte, North Carolina.
Callaghan O’Hare | Bloomberg | Getty Images
The company’s pharmacists have received specialized training on HIV conditions and drugs to treat and prevent the virus. A big part of that is how to start a conversation with patients who may be at risk.
“Getting patients to talk about their condition can be a challenge,” said pharmacist Gemima Kleine. “There’s a stigma around it and it’s better than it used to be, but it hasn’t gone away.”
This stigma can contribute to reluctance in some communities to seek treatment. But it is not the only problem of people who may be HIV positive.
Last year, while slightly more than half of non-Hispanic white patients had coverage for pre-exposure prophylaxis, known as PrEP, CDC data shows only 13.6% Latinos and 6.9% African Americans patients were reimbursed for drugs that help prevent transmission of the virus.
To help fill the gap, Walmart and two of its big drugstore rivals, CVS Health and Walgreenssigned the initiative of the Department of Health and Human Services end the HIV epidemic by 2030 by making antiviral drugs available and providing support services.
“There are certain drugs where maybe if you miss a dose, it’s not the worst, you won’t have that impact, but with HIV AIDS drugs, adherence is so important,” Kleine said.
CVS made HIV testing available at its minute clinics and helped patients get prescriptions without out-of-pocket costs through a government program known as Ready, Set, PrEP.
Similarly, Walgreens has trained more than 3,000 of its pharmacists to offer treatment counseling, provide ongoing testing and facilitate free home delivery of HIV medications to help encourage patient adherence to treatment regimens.
And Walmart has seen its outreach — to local health clinics and community groups that help patients get medical coverage in high-impact communities — starting to pay off.
“Once they know we have additional training and services to help their patients, we’ll start seeing them come in and that’s when we’ll start dealing with them,” Host said. “It’s been a really great marriage of community and business.”
On June 27, as part of National HIV Testing Day, Walmart will also join other pharmacies in offering free HIV testing at many of its specialty pharmacies.
The HIV program has expanded at a time when big pharma is focusing on expanding its healthcare services. They hope that initiatives like specialty pharmacies will highlight their role as community-based retail health care providers in the minds of consumers – and improve patient outcomes.
“I’m hoping they put something like this in small towns that maybe it’s harder to get things or they’re not aware of it,” Rosario said.
Correction: This story has been updated to clarify where Walmart will offer free HIV testing on June 27; the company will offer the program in selected pharmacies.