Trends in prescriptions for highly active antiretroviral therapy in four New York City HIV clinics.
OBJECTIVE
To describe trends in prescriptions for antiretroviral therapies and factors associated with prescriptions for highly active antiretroviral therapy (HAART).


METHODS
Medical records of patients at four HIV clinics in New York City were reviewed every 6 months. For the four 6-month periods 1997 to 1998, we identified patients with a CD4+ nadir <500 cells/microl; sample sizes were 434, 432, 503, and 643, respectively. Trends in HAART prescriptions were tested by logistic regression using robust variance estimates because some patients contributed more than one time period. Associations between HAART prescriptions and patient characteristics were tested by chi2 and multiple logistic regression analysis.


RESULTS
Patients were predominantly black or Hispanic (89%-90%) and male (66%-68%), and injection drug use was the most prevalent HIV risk (38%-49%). From 1997 to 1998, HAART prescriptions increased from 54% to 89% of antiretroviral prescriptions, and the proportion that included an nonnucleoside reverse transcriptase inhibitors (NNRTI) increased from 3% to 10%. HAART prescriptions were inversely associated with CD4+ nadir group during all time periods, and in the second half of 1998, patients with CD4+ nadir between 50 and 199 cells/microl were as likely to be prescribed HAART as the most immunosuppressed patients (CD4+ nadir <50 cells/microl; 91% versus 92%). HAART prescriptions were associated with clinic, HIV risk, and other patient characteristics in some time periods but not consistently.


CONCLUSIONS
In these four HIV clinics, prescriptions for HAART increased significantly from 1997 to 1998, leveling off at 89% in the second half of 1998. Increasingly, HAART was prescribed for healthier patients and included an NNRTI.
Sackoff
J E
JE
New York City Department of Health, Office of AIDS Surveillance, New York 10013, USA.
McFarland
J W
JW
Shin
S S
SS
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000554:Ambulatory Care Facilities / Q000639:trends; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000208:ethnology / Q000276:immunology; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009519:New York City / Q000453:epidemiology; D012307:Risk Factors; D044465:White People / Q000706:statistics & numerical data
D019380:Anti-HIV Agents