title: Intravenous drug use, relationship with providers, and stage of HIV disease influence the prescription rates of protease inhibitors.
abstract: OBJECTIVE
  To assess rates of prescriptions of protease inhibitors (PI) and determinants of not being prescribed PIs in a cohort of HIV-infected people eligible (according to published guidelines) for highly active antiretroviral therapy (HAART).
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  A total of 684 patients with CD4+ counts <500 cells/microl were enrolled from seven Italian HIV treatment centers from October 1997 to April 1998. A questionnaire on health-related quality of life (MOS-HIV) and patient ratings of the quality of care was administered. Sociodemographic variables, HIV disease-related factors, and prescribed antiretroviral therapy were also recorded.
  
  
  RESULTS
  61% of those enrolled were prescribed PI (median, 7.5 months). In addition, 75% of patients had previously received antiretroviral therapy. Fewer than 1% were prescribed nonnucleoside reverse transcriptase inhibitors (NNRTIs). Using multivariable logistic regression considering those with CD4+ counts <500 cells/microl, patients reporting the least information received (odds ratio [OR], 1.78; 95% confidence interval [CI], 1.23-2.58), injecting drug users (IDUs; OR, 1.73; 95% CI, 1.18-2.54), people with CD4+ counts >200 cells/microl (OR, 1.76; 95% CI, 1.19-2.61), and patients with early stage disease (OR, 2.24; 95% CI, 1.73-2.90) were less likely to have be prescribed PIs.
  
  
  CONCLUSIONS
  Of patients eligible for HAART, only 61% were prescribed PIs. People who wanted more information, IDUs, and patients in earlier disease stages are significantly less likely to be prescribed PIs. Access to HAART remains a critical issue in the management of HIV disease.
authors.affiliation: Department of Infectious Diseases, Catholic University, Rome, Italy. ritanto@iol.it
authors.forename: R
authors.initials: R
authors.lastname: Murri
authors.forename: M
authors.initials: M
authors.lastname: Fantoni
authors.forename: C
authors.initials: C
authors.lastname: Del Borgo
authors.forename: I
authors.initials: I
authors.lastname: Izzi
authors.forename: R
authors.initials: R
authors.lastname: Visonà
authors.forename: F
authors.initials: F
authors.lastname: Suter
authors.forename: M C
authors.initials: MC
authors.lastname: Banfi
authors.forename: E
authors.initials: E
authors.lastname: Barchi
authors.forename: N
authors.initials: N
authors.lastname: Orchi
authors.forename: O
authors.initials: O
authors.lastname: Bosco
authors.forename: A W
authors.initials: AW
authors.lastname: Wu
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D011307:Drug Prescriptions; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D017320:HIV Protease Inhibitors / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D010817:Physician-Patient Relations; D015819:Substance Abuse, Intravenous
chemical_list: D019380:Anti-HIV Agents; D017320:HIV Protease Inhibitors