Clinician Perspectives on Delaying Initiation of Antiretroviral Therapy for Clinically Eligible HIV-Infected Patients

Overview

Journal J Int Assoc Provid AIDS Care

Publisher Sage Publications

Specialty Infectious Diseases

Date 2014 Nov 15

PMID 25394912

Citations 21

Authors

Linda Beer

Eduardo E Valverde

Jerris L Raiford

John Weiser

Becky L White

Jacek Skarbinski

Affiliations

Soon will be listed here.

Abstract

Objectives: Guidelines for antiretroviral therapy (ART) initiation have evolved, but consistently note that adherence problems should be considered and addressed. Little is known regarding the reasons providers delay ART initiation in clinically eligible patients.

Methods: In 2009, we surveyed a probability sample of HIV care providers in 582 outpatient facilities in the United States and Puerto Rico with an open-ended question about nonclinical reasons for delaying ART initiation in otherwise clinically eligible patients.

Results: Very few providers (2%) reported never delaying ART. Reasons for delaying ART were concerns about patient adherence (68%), patient acceptance (60%), and structural barriers (33%). Provider and practice characteristics were associated with reasons for delaying ART.

Conclusion: Reasons for delaying ART were consistent with clinical guidelines and were both patient level and structural. Providers may benefit from training and access to referrals for ancillary services to enhance their ability to monitor and address these issues with their patients.

Citing Articles

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Past-year medical and non-medical opioid use by HIV status in a nationally representative US sample: Implications for HIV and substance use service integration.

West B, Diaz J, Philbin M, Mauro P J Subst Use Addict Treat. 2023; 147:208976.

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Jaurretche M, Byrne M, Happ L, Levy M, Horberg M, Greenberg A Epidemiol Infect. 2023; 151:e45.

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Current Antiretroviral Treatment Among People With Human Immunodeficiency Virus in the United States: Findings from the Centers for AIDS Research Network of Integrated Clinic Systems Cohort.

Ma J, Nance R, Delaney J, Whitney B, Bamford L, Gravett R Clin Infect Dis. 2022; 75(4):715-718.

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Gaps in the continuum of care among people living with HIV in Afghanistan.

Harooni M, Atarud A, Ehsan E, Alokozai A, McFarland W, Mirzazadeh A Int J STD AIDS. 2021; 33(3):282-288.

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