State Story
Virginia and Walgreens Collaborate to Provide Free HIV Testing in the Commonwealth
After establishing that they share a commitment to addressing HIV, the Virginia Department of Health
and Walgreens created a program that provides free, pharmacist-led HIV testing at select Walgreens
sites.
The Virginia Department of Health (VDH) and Walgreens announced in June 2014 that they partnered to
offer free and confidential rapid HIV testing throughout the commonwealth in Walgreens pharmacies.
This unique collaboration aims to increase testing among at-risk populations and improve linkages to
HIV care for patients identified through the program, with a goal
of testing 5,000 people in its first year.
The launch was the culmination of almost two years of work,
beginning in July 2012 when VDH Community HIV Testing
Coordinator Heather Bronson cold-called the Walgreens
customer service line and pitched her vision for the
collaboration. VDH had previously collaborated with Walgreens
and Greater Than AIDS to offer free testing on National HIV
Testing Day, which had established that both organizations are
committed to the issue and could work well together.
Within hours of Bronson leaving a message with a customer
service representative, Walgreens Senior Director of Virology
Glen Pietrandoni returned the call from Walgreens headquarters
in Chicago, excited about the concept. They agreed that their
goal was to provide free, pharmacist-led HIV testing as a
permanent service, not just for a national testing day.
Approximately 1,000 new cases of HIV are diagnosed in Virginia
each year, and roughly 25,000 people with HIV live in the
commonwealth. Moreover, approximately 18 percent of people
living with HIV in the United States don’t know that they have it.
By bringing free testing to the state—particularly to rural and
underserved areas—VDH hoped to overcome concerns about
test costs and confidentiality.
“In rural and underserved areas, people are often nervous about
going to places for testing where they might see people they
know, but your pharmacist already knows a great deal about
your health and has to keep results confidential,” says Bronson.
Steps Taken:
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 In the first four
months of the
Virginia-Walgreens
HIV testing
collaboration,
Walgreen
pharmacists
administered more
than 500 tests.
 Forty-four percent of
test recipients were
between the ages of
18-29. Sixty-four
percent were African
American, Latino, or
identified with more
than one racial or
ethnic group.
 VDH and Walgreens
plan to have free
testing in additional
Walgreens locations
by January 2015.
To support their collaboration, VDH and Walgreens used
© Association of State and Territorial Health Officials 2014
2231 Crystal Drive, Ste 450, Arlington, VA
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State Story
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funding from the Care and Prevention in the United States (CAPUS) Demonstration Project,
which aims to reduce HIV and AIDS-related morbidity and mortality among racial and ethnic
minorities and improve linkages to care.
During the initial planning stages, VDH and Walgreens representatives spoke every two weeks.
During this time, VDH applied for its CAPUS grant, received the award, and completed its federal
partners’ requirements. Once it finished those steps, VDH and Walgreens began holding calls
every week.
Using the CAPUS focus, VDH and Walgreens targeted areas with high levels of poverty or large
minority populations. “We looked at census data and laid them on top of maps of Walgreens
locations to pinpoint the stores that would best reach those at risk,” says Bronson. The team
also only selected sites that had private consultation rooms to conduct confidential testing.
Based on these criteria, the collaboration team chose 13 stores to offer free HIV testing.
The team worked with the stores to make sure that they had relationships with their local
health departments (LHDs). This allows the stores to connect clients who receive positive HIV
results with LHDs so they can receive confirmatory testing, referrals, and linkages to care.
VDH also provided participating Walgreens pharmacies with area-specific referral cards and a
statewide referral list, and the pharmacies have 24-hour phone access to a Virginia Division of
Disease Prevention (VDDP) staffer if they need help linking a client to a disease intervention
specialist (DIS) at an LHD or a community-based organization (CBO).
Although VDH and Walgreens had planned the program together from the beginning, the VDH
procurement officer asked Walgreens to go through the department’s procurement process to
ensure that the program adhered to the commonwealth’s guidelines.
Because Walgreens emphasized the importance of providing training to the pharmacists who
would be administering the tests, VDH created a comprehensive training program.
The team discussed issues that might arise during the testing and how to mitigate them. For
example, the team decided to use a rapid test that could provide results in as little as one
minute instead of 15- or 20-minute tests, with the goal of reducing the likelihood that clients
would get nervous about their results and leave the pharmacies before receiving them.
VDH had not previously worked with rapid HIV tests, so it had to create quality assurance
documentation before offering it in the stores.
VDH and representatives from Walgreens headquarters walked through the testing prior to
launch to help ensure that it worked smoothly. They also role-played various client scenarios,
which allowed them to determine how to talk to clients about the test and advertise it.
The program launched on June 24, 2014. To promote it, VDH and Walgreens held a launch event
in a Henrico County store, where VDH Commissioner Marissa J. Levine and Walgreens Vice
President Darron Briscoe provided remarks. The team has also promoted the testing through
media advertisements, Walgreens advertisements, handouts, and social media.
Results:
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From June to September 2014, the Virginia free HIV testing program administered 520 tests.
Of those test recipients, 44 percent were between the ages of 18-29. Sixty-four percent were
African American, Latino, or identified with more than one racial or ethnic group. Fifty-one
percent were women, 47 percent were men, and one individual was transgender.
© Association of State and Territorial Health Officials 2014
2231 Crystal Drive, Ste 450, Arlington, VA
Visit ASTHO’s complete story archive at www.astho.org/stories
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Of the 520 clients tested, two received positive test results, and one client initially received a
positive test result but received a negative result upon confirmatory testing. Of these three
clients, one was followed by a CBO, one by a DIS, and one initially refused assistance but later
followed up with VDDP staff. The seropositivity rate will likely rise as word of the project spreads
and the program reaches more members of its target audience.
Due to the program’s initial success, Walgreens plans to expand its locations where free HIV
testing is available. Additional locations are being planned for January 2015.
Next Steps:
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VDH will continue to collect data to ensure that it is meeting its target audience.
The team has already found some areas with lower testing rates than expected, so it will
increase its advertising in those regions.
VDH and Walgreens hold weekly calls to assess how the testing program is doing. They also
conduct meetings with district managers to work through new developments and discuss what
the pharmacists are saying about the program, what support they need, and what can be done
to improve the HIV testing training.
To further improve HIV testing in the participating stores, VDH and Walgreens are working with
CDC to offer the Rapid HIV Testing Training online course to Walgreens pharmacists.
Lessons Learned:
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Identify a partner who is already committed to the same issue. VDH and Walgreens have been
able to successfully collaborate because they share a commitment to HIV testing and had
previously worked together on a short-term testing project, National HIV Testing Day. "It takes
all of us—public health, the private sector, and community based organizations—working
together to overcome the toughest of health challenges," Levine said in a press release.
Generate buy-in from supervisors and leaders within your department. “Dr. Levine has been a
great support,” says Bronson. “One of the things we wanted to do was to give the initiative a
good launch. She stepped in to help us—she attended the floor launch, talked to Walgreens
staff, and talked to the media. Any time you can have your commissioner speak at your event, it
raises its profile, which gives you more freedom and access.”
Be open to out-of-the-box ideas. “For me, this project has been a reminder of the power of one
person’s great idea,” says Diana Jordan, VDDP director. “When you work in a large system, it can
be hard to remember that.”
Work with the partners’ legal departments early in the planning process to ensure that the work
meets legal requirements. VDH and Walgreens were able to quickly obtain the necessary
permissions from Walgreens’ counsel, but they later experienced a two-month implementation
delay after learning that Walgreens needed to apply for the program via a procurement process.
Keep pushing forward and addressing challenges as partners. “I was blown away by the
Walgreens staff’s positivity and willingness to keep coming back to the table, even when there
were challenges,” says Bronson. “Having that ‘yes, we’ll make it work’ mentality was incredible.”
© Association of State and Territorial Health Officials 2014
2231 Crystal Drive, Ste 450, Arlington, VA
Visit ASTHO’s complete story archive at www.astho.org/stories
State Story
For more information:
Heather Bronson
Community HIV Testing Coordinator
Virginia Department of Health
Email: [email protected]
Diana Jordan
Director of the Division of Disease Prevention
Virginia Department of Health
Email: [email protected]
Virgie Townsend
Senior Editor, Communications and Social Media
Association of State and Territorial Health Officials
Email: [email protected]
© Association of State and Territorial Health Officials 2014
2231 Crystal Drive, Ste 450, Arlington, VA
Visit ASTHO’s complete story archive at www.astho.org/stories