Treatment as prevention: are Argentinean HIV care providers willing to adopt earlier antiretroviral therapy?

HIV guidelines increasingly recommend antiretroviral therapy (ART) initiation at a higher CD4 levels. The extent to which these evolving standards are translated into routine clinical care has not been evaluated in Argentina. During October 2012, we conducted an online survey among Argentinean HIV c...

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Bibliographic Details
Published in:AIDS care 2014-11, Vol.26 (11), p.1446-1451
Main Authors: Socías, María Eugenia, Sued, Omar, Pryluka, Daniel, Patterson, Patricia, Fink, Valeria, Cesar, Carina, Cahn, Pedro
Format: Article
Language:English
Subjects:
Adult
AIDS/HIV
Anti-Retroviral Agents - administration & dosage
Antiretroviral drugs
antiretroviral therapy
Antiretroviral Therapy, Highly Active
Argentina
Attitude of Health Personnel
Attitudes
Biological and medical sciences
CD4 Lymphocyte Count
Disease prevention
Female
Health care industry
Health Care Surveys
HIV
HIV Infections - drug therapy
HIV Infections - prevention & control
HIV Infections - transmission
HIV Infections - virology
HIV prevention
Human immunodeficiency virus
Human viral diseases
Humans
Immunodeficiencies
Immunodeficiencies. Immunoglobulinopathies
Immunopathology
Infectious diseases
Male
Medical sciences
Middle Aged
Patients
Physicians
Practice Patterns, Physicians
Risk
Secondary Prevention
Sex workers
survey
Surveys
treatment as prevention
Viral diseases
Viral diseases of the lymphoid tissue and the blood. Aids
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Summary:HIV guidelines increasingly recommend antiretroviral therapy (ART) initiation at a higher CD4 levels. The extent to which these evolving standards are translated into routine clinical care has not been evaluated in Argentina. During October 2012, we conducted an online survey among Argentinean HIV clinicians to assess their attitudes and practices toward ART initiation and its potential use for HIV prevention. Of the 280 physicians included, 61% would prescribe ART at CD4 ≤500 cells/µL for asymptomatic patients. Although, only 11% would recommend ART irrespective of CD4 cell count, 72% would do it for serodiscordant couples, and 75% for sex workers. Most participants agreed that they would consider earlier initiation of ART if transmission risk exists, and that expansion of ART could help decrease HIV incidence. These results suggest that a large proportion of Argentinean HIV care providers are willing to adopt the recently updated Argentinean guidelines recommending earlier ART, especially when high HIV transmission risk exists.
ISSN:0954-0121
1360-0451
DOI:10.1080/09540121.2014.915286