Differences in prescription of antiretroviral therapy in a large cohort of HIV-infected patients

A. D. McNaghten, Debra L. Hanson, Mark S. Dworkin, Jeffrey L. Jones, Jane Turner, Amy Wohl, David Cohn, Arthur Davidson, Cornelius Rietmeijer, Julia Gable, Melanie Thompson, Stephanie Broyles, Anne Morse, Eve Mokotoff, Linda Wotring, Judy Sackoff, Maria De los Angeles Gomez, Robert Hunter, Jose Otero, Sandra MirandaSharon Melville, Sylvia Odem, Philip Keiser, Wes McNeely, Kaye Reynolds, Susan Buskin, Sharon Hopkins

Research output: Contribution to journalArticle

64 Scopus citations

Abstract

The objective of this study was to determine factors associated with prescription of highly active antiretroviral therapy (HAART). The authors observed 9530 patients eligible for antiretroviral therapy (ART) in more than 100 hospitals and clinics in 10 US cities. Multiple logistic regression analysis was used to assess factors associated with HAART prescription, stratifying patients by no history versus history of ART to assess the association between prescription and CD4, viral load, and outpatient visits. Overall, female gender (odds ratio [OR], 0.68; 95% confidence interval [CI], 0.60-0.76) and alcoholism (OR, 0.85; 95% CI, 0.74-0.99) were associated with decreased likelihood of HAART prescription. Enrollment at a private facility (OR, 1.33; 95% CI, 1.14-1.56), heterosexual exposure (OR, 1.34; 95% CI, 1.13-1.58), and Hispanic ethnicity (OR, 1.19; 95% CI, 1.04-1.37) were associated with prescription. For patients with no history of prescribed ART, CD4 <500 cells/μL (OR, 3.94; 95% CI, 2.02-7.66), and high viral load were associated with increased likelihood of prescription; for patients with history of ART prescription, those whose outpatient visits averaged ≥2 per 6-month interval (OR, 1.30; 95% CI, 1.10-1.54) were more likely and those with high viral load were less likely to be prescribed HAART (OR, 0.50; 95% CI, 0.44-0.56). The authors found differences in HAART prescription by gender, race, exposure mode, alcoholism, and provider type for all patients, by CD4 and viral load for patients with no history of ART prescription, and by average number of outpatient visits and viral load for patients with history of ART prescription.

Original languageEnglish (US)
Pages (from-to)499-505
Number of pages7
JournalJournal of Acquired Immune Deficiency Syndromes
Volume32
Issue number5
DOIs
StatePublished - Apr 15 2003
Externally publishedYes

Keywords

  • Antiretroviral therapy
  • HAART prescription
  • Highly active antiretroviral therapy (HAART)

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

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    McNaghten, A. D., Hanson, D. L., Dworkin, M. S., Jones, J. L., Turner, J., Wohl, A., Cohn, D., Davidson, A., Rietmeijer, C., Gable, J., Thompson, M., Broyles, S., Morse, A., Mokotoff, E., Wotring, L., Sackoff, J., De los Angeles Gomez, M., Hunter, R., Otero, J., ... Hopkins, S. (2003). Differences in prescription of antiretroviral therapy in a large cohort of HIV-infected patients. Journal of Acquired Immune Deficiency Syndromes, 32(5), 499-505. https://doi.org/10.1097/00126334-200304150-00006