Title

How Providers Treat HIV: An Analysis of Provider Opinion and Adoption of the 2012 DHHS Guidelines for the use of Antiretroviral Agents in HIV-1 Infected Adults and Adolescents

Document Type

Presentation

Publication Date

12-4-2013

Comments

Capstone Committee:

Dr. Richie Brawer, Chair

Abstract

On March 27, 2012, the Department of Health and Human Services updated the Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents, which now recommend an HIV-provider start all HIV-positive patients on antiretroviral therapy (ART), regardless of CD4 count. In the past, the guidelines used a patient’s CD4 count, which measures the strength of an individual’s immune system, as the marker to start ART. The panel that updates the DHHS HIV guidelines cited new evidence that showed the use of ART helped slows disease progression to AIDS and decreases transmission of the HIV virus to non-HIV infected individuals. If the guidelines are implemented, HIV epidemiology will change. Providers are a cornerstone in adopting the new practice; yet their opinion about the new guidelines remains largely unknown. The purpose of this study was to assess HIV provider opinion and adoption of the updated March 2012 Department of Health and Human Services Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents. Data were obtained through a qualitative interview and survey distributed to HIV providers in Philadelphia County. Survey and interview responses were categorized to determine the frequency and themes which guided how HIV providers treat HIV-positive patients. Survey and interview responses revealed 3 overarching factors that guided how HIV providers treat HIV: medical, social and policy. Interviews also identified a possible gap between the effectiveness and efficiency with which providers at different institutions are made aware of and adopt evidence-based research. Recommendations include potential strategies for reducing delay of guideline uptake through educational opportunities and partnerships between academia and community providers.

Presentation: 29 minutes