Intravenous drug use, relationship with providers, and stage of HIV disease influence the prescription rates of protease inhibitors

Rita Murri, Massimo Fantoni, Cosmo Del Borgo, Immacolata Izzi, Raffaella Visonà, Fredy Suter, Maria Cristina Banfi, Enrico Barchi, Nicoletta Orchi, Oliviero Bosco, Albert W. Wu

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To assess rates of prescriptions of protease inhibitors (PI) and determinants of not being prescribed PIs in a cohort of HIV-infected people eligible (according to published guidelines) for highly active antiretroviral therapy (HAART). Design: Cross-sectional survey. Methods: A total of 684 patients with CD4+ counts <500 cells/μl were enrolled from seven Italian HIV treatment centers from October 1997 to April 1998. A questionnaire on health-related quality of life (MOS-HIV) and patient ratings of the quality of care was administered. Sociodemographic variables, HIV disease-related factors, and prescribed antiretroviral therapy were also recorded. Results: 61% of those enrolled were prescribed PI (median, 7.5 months). In addition, 75% of patients had previously received antiretroviral therapy. Fewer than 1% were prescribed nonnucleoside reverse transcriptase inhibitors (NNRTIs). Using multivariable logistic regression considering those with CD4+ counts <500 cells/μl, patients reporting the least information received (odds ratio [OR], 1.78; 95% confidence interval [CI], 1.23-2.58), injecting drug users (IDUs; OR, 1.73; 95% CI, 1.18-2.54), people with CD4+ counts >200 cells/μl (OR, 1.76; 95% CI, 1.19-2.61), and patients with early stage disease (OR, 2.24; 95% CI, 1.73-2.90) were less likely to have be prescribed PIs. Conclusions: Of patients eligible for HAART, only 61% were prescribed PIs. People who wanted more information, IDUs, and patients in earlier disease stages are significantly less likely to be prescribed PIs. Access to HAART remains a critical issue in the management of HIV disease.

Original languageEnglish (US)
Pages (from-to)461-466
Number of pages6
JournalJournal of Acquired Immune Deficiency Syndromes and Human Retrovirology
Volume22
Issue number5
StatePublished - Dec 15 1999

Keywords

  • Access to care
  • Antiretroviral therapy
  • Intravenous drug users
  • Patient-provider relationship
  • Prescription
  • Protease inhibitors

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Virology

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