title: Changing Clinician Practices and Attitudes Regarding the Use of Antiretroviral Therapy for HIV Treatment and Prevention.
abstract: As part of the HPTN 065 study in the Bronx, New York and Washington, the authors, we surveyed clinicians to assess for shifts in their practices and attitudes around HIV treatment and prevention. Antiretroviral therapy (ART)-prescribing clinicians at 39 HIV care sites were offered an anonymous Web-based survey at baseline (2010-2011) and at follow-up (2013). The 165 respondents at baseline and 141 respondents at follow-up had similar characteristics-almost 60% were female, median age was 47 years, two-thirds were physicians, and nearly 80% were HIV specialists. The percentage who reported recommending ART irrespective of CD4 count was higher at follow-up (15% versus 68%), as was the percentage who would initiate ART earlier for patients having unprotected sex with partners of unknown HIV status (64% versus 82%), and for those in HIV-discordant partnerships (75% versus 87%). In line with changing HIV treatment guidelines during 2010 to 2013, clinicians increasingly supported early ART for treatment and prevention.
authors.affiliation: 1 Division of HIV/AIDS Prevention, US Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Kate
authors.initials: K
authors.lastname: Buchacz
authors.affiliation: 2 FHI360, Durham, NC, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Farrior
authors.affiliation: 3 Statistical Center for HIV/AIDS Research and Prevention, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
authors.forename: Geetha
authors.initials: G
authors.lastname: Beauchamp
authors.affiliation: 3 Statistical Center for HIV/AIDS Research and Prevention, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
authors.forename: Laura
authors.initials: L
authors.lastname: McKinstry
authors.affiliation: 4 Yale University School of Nursing, New Haven, CT, USA.
authors.forename: Ann E
authors.initials: AE
authors.lastname: Kurth
authors.affiliation: 5 Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY.
authors.forename: Barry S
authors.initials: BS
authors.lastname: Zingman
authors.affiliation: 6 Veterans Affairs Medical Center, George Washington University, Washington DC, USA.
authors.forename: Fred M
authors.initials: FM
authors.lastname: Gordin
authors.affiliation: 3 Statistical Center for HIV/AIDS Research and Prevention, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
authors.forename: Deborah
authors.initials: D
authors.lastname: Donnell
authors.affiliation: 7 Fenway Health, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
authors.forename: Kenneth H
authors.initials: KH
authors.lastname: Mayer
authors.affiliation: 8 ICAP at Columbia University, Mailman School of Public Health, Columbia University and Harlem Hospital, New York, NY, USA.
authors.forename: Wafaa M
authors.initials: WM
authors.lastname: El-Sadr
authors.affiliation: 1 Division of HIV/AIDS Prevention, US Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Bernard
authors.initials: B
authors.lastname: Branson
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010820:Physicians / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*
chemical_list: D044966:Anti-Retroviral Agents
keywords: ART; HIV prevention; clinician survey; early antiretroviral therapy; test and treat