Journal article
Diffusion of Newer HIV Prevention Innovations: Variable Practices of Frontline Infectious Diseases Physicians
Clinical infectious diseases, Vol.62(1), pp.99-105
01/01/2016
DOI: 10.1093/cid/civ736
PMCID: PMC4678105
PMID: 26385993
Abstract
Background. US Public Health Service guidelines recommend early initiation of antiretroviral treatment (ART) for human immunodeficiency virus infection (HIV)-infected patients and preexposure prophylaxis (PrEP) as a prevention option for persons at risk for HIV acquisition. Before issuance of these guidelines, few clinicians reported prescribing early ART or PrEP.
Methods. The Emerging Infections Network, a national network of infectious diseases physicians in the United States and Canada, was surveyed in September 2014 to assess practices of adult HIV-care providers with early ART, PrEP, and other guideline-recommended HIV prevention methods.
Results. Almost half of the 1191 active members invited (48.1%) participated; 415 (72.4%) were HIV-care providers. Most providers (86.5%) indicated that they typically recommended ART initiation at diagnosis, irrespective of CD4(+) cell count. However, for patients with a CD4(+) cell count >500/mu L, clinicians would defer ART if patients did not feel ready to initiate ART (94.7%) or had uncontrolled substance abuse (66.0%). Many providers had counseled HIV-infected patients about PrEP for partners (59.0%) or offered visits for partners to discuss PrEP (40.7%), and 31.8% had prescribed PrEP. Clinicians who deferred ART were less likely to endorse and engage in aspects of PrEP provision.
Conclusions. Concordant with guidelines, most infectious diseases physicians recommend early ART, and many have experience with aspects of PrEP provision, suggesting recent evolution of clinician practices. Providers who defer ART are also cautious about PrEP. Interventions that help physicians motivate patients to initiate ART and identify missed opportunities to provide PrEP could enhance HIV prevention.
Details
- Title: Subtitle
- Diffusion of Newer HIV Prevention Innovations: Variable Practices of Frontline Infectious Diseases Physicians
- Creators
- Douglas S. Krakower - Beth Israel Deaconess Medical CenterSusan E. Beekmann - University of IowaPhilip M. Polgreen - Roy J. and Lucille A. Carver College of MedicineKenneth H. Mayer - Beth Israel Deaconess Medical Center
- Resource Type
- Journal article
- Publication Details
- Clinical infectious diseases, Vol.62(1), pp.99-105
- DOI
- 10.1093/cid/civ736
- PMID
- 26385993
- PMCID
- PMC4678105
- NLM abbreviation
- Clin Infect Dis
- ISSN
- 1058-4838
- eISSN
- 1537-6591
- Publisher
- Oxford Univ Press
- Number of pages
- 7
- Grant note
- K23 MH098795 / National Institute of Mental Health at the NIH K23MH098795 / NATIONAL INSTITUTE OF MENTAL HEALTH; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Mental Health (NIMH) P30 AI060354 / Harvard University Center for AIDS Research, a NIH P30AI060354 / NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Allergy & Infectious Diseases (NIAID) FOA CK11-1102 / CDC; United States Department of Health & Human Services; Centers for Disease Control & Prevention - USA
- Language
- English
- Date published
- 01/01/2016
- Academic Unit
- Infectious Diseases; Epidemiology; Injury Prevention Research Center; Internal Medicine
- Record Identifier
- 9984359890502771
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