Management of sexually transmitted infections: a qualitative assessment of community pharmacy practices in the Ho Municipality, Ghana.

Background: Effective management of sexually transmitted infections (STIs) is crucial in the control and spread of these infections in health systems. Community pharmacies are usually the first port of call in Ghana for most people who contract STIs for therapy. Delayed and inappropriate treatment contributes significantly to treatment failures, drug resistance and complications. However, the community pharmacies may not have diagnostic tools and trained personnel for prompt case detection and appropriate therapeutic action. Thus, posing a higher risk for inappropriate therapy with consequences of worsening symptoms and poor treatment outcomes. This study explored the STI management practices in community pharmacies in the Ho Municipality.

Methods: Purposively selected study participants were community pharmacy staff including Pharmacists (n = 6), Pharmacy Technicians (n = 2) and Dispensing Assistants (n = 10) in outlets in Ho Municipality of the Volta region, Ghana. Data collection was carried out from December 2020 to January 2021. In-depth interviews of the participants using a semi-structured interview guide were conducted and recorded. Data obtained was transcribed and analyzed using NVivo version 12 using the thematic framework.

Results: Some of the pharmacy staff were unaware of National Standard Treatment Guidelines (STG) and its recommendations for STI management. More than half of the participants believed the STG recommendations were important for therapy but few thought the STG recommendations were ineffective sometimes. Appropriate STI management practices observed included infection treatment based on laboratory data, and STG protocols that recommend syndromic approach. Negative STI management practices included disregarding the presence of possible mixed infections and treating all symptoms observed empirically as a single infection without laboratory confirmation.

Conclusion: The STI management practices in the community pharmacies had many gaps that risk infective therapy, treatment failures, STI complications, and antibiotic resistance. Efforts should be invested into the training of practitioners in community pharmacies for safe and effective practices for STI management, and encouraged to have diagnostic kits or work with laboratory facilities for testing to inform definitive therapy for optimal outcomes.