Association of Provider and Patient Characteristics With HIV-Infected Women's Antiretroviral Therapy Regimen
| Autor: | Barbara J. Turner, Daozhi Zhang, Leon Cosler, Christine Laine, Walter W. Hauck, Roger J. Pomerantz |
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| Rok vydání: | 2001 |
| Předmět: |
Adult
Pediatrics medicine.medical_specialty Anti-HIV Agents Pharmacy HIV Infections Acquired immunodeficiency syndrome (AIDS) Pregnancy Antiretroviral Therapy Highly Active medicine Humans Pharmacology (medical) Medical prescription Practice Patterns Physicians' business.industry Odds ratio Patient Acceptance of Health Care medicine.disease Substance abuse Clinical trial Regimen Infectious Diseases Immunology HIV-1 Reverse Transcriptase Inhibitors Drug Therapy Combination Female business Methadone medicine.drug |
| Zdroj: | Journal of Acquired Immune Deficiency Syndromes. 27:20-29 |
| ISSN: | 1525-4135 |
| DOI: | 10.1097/00042560-200105010-00004 |
| Popis: | OBJECTIVE We explored the effect of patient and provider factors on the type of antiretroviral regimen among women receiving therapy. PATIENTS Five hundred ninety-five New York State nonpregnant HIV+ women with full Medicaid eligibility and at least 1 month of a prescribed antiretroviral regimen in federal fiscal years (FFY) 1997-1998 and intervals in FFY 1997-1998, who had delivered a liveborn baby within 5 years. MEASUREMENTS From pharmacy claims in 4 6-month intervals in FFY 1997-1998, data were extracted on (1) an acceptable > or = 2 antiretroviral combination regimen per expert guidelines; and (2) a highly active regimen, including a protease inhibitor or nonnucleoside analog (highly active antiretroviral therapy [HAART]). RESULTS Of 1514 woman-6-month intervals with filled antiretroviral prescriptions, 82% had an acceptable regimen, and of 1246 woman-6-month intervals on acceptable antiretroviral therapy, half demonstrated the use of HAART. Adjusted odds ratios (AORs) of acceptable antiretroviral therapy were higher (p < .05) for HIV specialty care (AOR = 1.71 for one or two visits; AOR = 2.10 for 3+ visits) or HIV clinical trials site care (AOR = 1.43; 95% confidence interval [CI]: 1.01, 2.04). Among women on acceptable antiretroviral regimens, those aged older than 25 years (AOR = 1.69; CI: 1.13, 2.53) or who were high school graduates (AOR = 1.50; CI: 1.09, 2.06) had higher odds of HAART. Methadone-treated women had twofold and nearly threefold higher AORs of acceptable antiretroviral regimens and HAART, respectively, than current drug users. CONCLUSION Provider HIV expertise is associated with receipt of an acceptable antiretroviral regimen in women, although receipt of HAART is affected more by age, education, and current drug abuse. Methadone treatment seems to improve access to acceptable antiretroviral regimens as well as to HAART. |
| Databáze: | OpenAIRE |
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