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Dr. Kyle Wilby, associate professor and associate director of program evaluation in the College of Pharmacy, is co-leading a much-needed and nationally-anticipated research project: Improving sexual health for Canadians through a pharmacy-based sexual health services model.

The research project has received a Transforming Health with Integrated Care (THINC) Implementation Science Team (IST) Grant from the Canadian Institutes of Health Research (CIHR). The grant has a value of $1.9 million and will be distributed over a five-year period. Dr. Debbie Kelly (pictured left), professor in Memorial University of Newfoundland’s School of Pharmacy, is Dr. Wilby’s collaborator and the project’s lead and principal applicant.

“The grant will be used to develop knowledge about how to scale, sustain, and pay for pharmacy-based sexual health services (PbSHS) model projects. Our project aims to understand the factors that go into sustaining research into practice, and to help provinces scale services up to a point where a patient could receive a full suite of sexual health services in pharmacies,” Dr. Wilby says.

The PbSHS model has been proven to reduce the strain on the primary health care system by increasing the range of pharmacies’ service offerings. Moreover, it improves patient accessibility to sexual health services.

Dr. Wilby explains how individuals from vulnerable and underserved populations (2SLGBTQIA+, people who use drugs, racially diverse individuals, immigrants, refugees, and people with disabilities) are more likely to face barriers to sexual health care. Some potential barriers include not having access to a regular health care professional, and experiences of discrimination and stigma in communities and health care systems alike.

“In my research within the 2SLGBTQIA+ population, we’ve found that people have or have had, in the Maritime provinces in particular, negative experiences within health care settings where it doesn’t make them really want to go and seek care, so they delay care, and/or they avoid care,” Dr. Wilby says.

The project aligns with Dr. Wilby’s areas of research, which include 2SLGBTQIA+ health, program implementation and evaluation, health and cultural safety training for healthcare professionals, and more. His responsibilities as project co-lead include facilitating communication between different groups, leading research teams, conducting project recruitment, seeking stakeholder feedback, supervising graduate and PharmD students, and various other duties.

“One of the key goals of this project is to build capacity and to help train students in research, and Dalhousie students will definitely be getting involved,” Dr. Wilby says.

The project will be conducted in three phases. The first phase will consist of scalability assessments to determine provinces’ levels of preparedness for the PbSHS model’s implementation. These assessments will include consultations with pharmacists, pharmacy support staff, stakeholders, and patients to determine how the model can be made more accessible, and which factors are essential for its success.

The project’s second phase will consist of stakeholder consultations to revise the PbSHS model’s implementation plans. The project’s third phase will aim to increase public and stakeholder awareness of and increase capacity for the PbSHS model’s implementation across the country.

Project background

The project is based on learnings from four in-progress PbSHS projects in Alberta, Newfoundland and Labrador, and Nova Scotia. Dr. Kelly initiated the first of these projects, entitled APPROACH, back in 2017. The project’s first phase monitored the introduction of Human Immunodeficiency Virus (HIV) testing in pharmacies across Newfoundland and Labrador and Alberta. The project’s second phase (APPROACH 2.0), which implemented HIV, Hepatitis C, and Syphilis testing in pharmacies across Newfoundland and Labrador, Alberta, and Nova Scotia, was launched on December 1, 2022: World AIDS (Acquired Immunodeficiency Syndrome) Day. This study is still actively recruiting people to be tested in pharmacies and more information can be found at the study website.

“I thought it was really innovative to have those services in pharmacies,” Dr. Wilby says.

Inspired by APPROACH’s innovative and successful framework, Dr. Wilby initiated the PrEP-Rx - Pharmacist Prescribing of Pre-Exposure Prophylaxis (PrEP) for HIV project in Nova Scotia in February 2023. In Alberta, two more PbSHS projects have also been launched for treatment of Hepatitis C and other sexually transmitted infections.

All four initial PbSHS projects have been receiving positive feedback from pharmacists, pharmacy support teams, and community members. The projects’ pharmacists have reported that providing sexual health services offers them the opportunity to discuss the full scope of their professional capabilities with patients. Ultimately, the projects have been empowering patients to view their pharmacists as links with the greater health care system.

“Pharmacy patients were saying: ‘I went to my pharmacist for PrEP prescribing, but I didn’t know that they could prescribe for other things, or give me a vaccine, or refer me to a mental health professional,’” Dr. Wilby says.