Bronx Pharmacist Has Golden Touch With AIDS Patients
Vast Majority of Those Afflicted Refill Medications Regularly

By JILL GARDINER Staff Reporter of the Sun

Joel Zive is a third-generation pharmacist, who started in the business as a kid, stocking shelves in his dad’s Lydig Avenue store in the Bronx.

Now, three decades later and two blocks down the street, he and his dad, Gerald Zive, have carved out a unique niche in serving the community’s largely minority HIV population.

On Friday, Mr. Zive, 43, will depart for Bangkok to attend the 15th International AIDS Conference, which accepted a 250-word abstract he wrote on the high refill rates his small Bronx pharmacy has achieved.

The pharmacy consistently sees 80% to 90% of its HIV patients ordering monthly refills, indicating that the overwhelming majority of them are sticking to their physically demanding HIV treatment regimens.

That is no small accomplishment. Getting patients to take HIV medications, including some that have unpleasant side effects, is one of the most difficult challenges in delivering HIV care.

Though statistics vary, one recent report suggests that AIDS patients in America generally only take 70% of their medications. Some, like Mr. Zive, say overall “adherence” rates are closer to 50% and point out that skipping medications causes the body to build drug resistance, making the virus harder to suppress.

Mr. Zive attributes the pharmacy’s success to its hands-on approach and the close relationships it maintains with its clients and health-care providers. The pharmacy has two HIV-positive employees, who work with newly diagnosed patients. The employees, both Hispanic women, also phone customers to remind them to refill medications.

“You have to look at it as an inverted pyramid,” Mr. Zive told The New York Sun last week in the pharmacy’s small counseling office. With a green marker in hand, Mr. Zive drew a diagram on the dry board behind him and continued: “When you are first diagnosed, provided you have a non-resistant virus, you have a lot of treatment options. But if you screw up the first treatment by skipping days, you end up with fewer choices.”

“These blue things here,” he said, moving over to a model white blood cell with large wart-like spheres affixed to its sides, “these are the HIV virus. Some people get totally freaked out by this. But for those who don’t, this visual aid acts as an excellent tool to demonstrate the importance of adhering to medications.”

Zive Pharmacy & Surgical Inc. has never been a traditional operation. From the time Gerald Zive opened it in 1963, in the then largely Jewish and Italian neighborhood, it has specialized in prescriptions, over-the-counter medications, and medical accessories.

It does not sell the shampoos and paper towels that line the shelves of other pharmacies, but it has several large glass cases filled with glucose meters, which diabetics use to measure blood-sugar levels, and other hard-to-find devices.

The pharmacy fills medications for just about everything, but the Zives estimate that 30% to 40% of the business, is devoted to HIV.

The younger Zive acknowledges that filling HIV medications is a relatively lucrative niche and says the realities of the industry, which include competing with large corporate chains, require pharmacies to be business-minded, he said.

But, more than the finances, he said, specializing in HIV stemmed from an intensive program he participated in at Johns Hopkins on HIV. Now, the specialty seems to have grown into a calling, one that has taken him to conferences, lectures, community clinics, and now to Bangkok.

Mr. Zive’s abstract was one of 10,000 submitted to this year’s conference and one of 8,641 accepted. It will not be accompanied by a presentation, but it will be included in a massive poster display.

And just attending the conference, the pharmacists said, will be an opportunity to share his model and to gather new ideas to implement in the Bronx when he returns.