TY - JOUR
T1 - Schizophrenia, AIDS and the decision to prescribe HAART results of a national survey of HIV clinicians
AU - Himelhoch, Seth
AU - Powe, Neil R.
AU - Breakey, William
AU - Gebo, Kelly A.
PY - 2006
Y1 - 2006
N2 - Individuals with schizophrenia are at risk of developing HIV and are known to experience barriers to optimal medical care. Our goal was to determine, among a cohort of HIV clinicians, whether or not the diagnosis of schizophrenia affected the clinical decision to offer highly active antiretroviral therapy (HAART) to AIDS patients. This is a cross-sectional study of a random, national sample of HIV experts drawn from the membership of the American Academy of HIV Medicine. Participants were mailed a self-administered questionnaire with a case vignette of a new onset AIDS patient and were specifically asked whether or not they would recommend HAART treatment. Vignettes were randomly assigned to include a diagnosis of schizophrenia or not. We located 649 clinicians (93%); 347 responded (53.4%). Responders and non-responders did not differ in demographics or work characteristics. Recommendation of antiretroviral treatment did not differ between those who received a case vignette with schizophrenia versus those who did not (95.8% vs. 96.6%, p = 0.69). Compared to those who received a case vignette without schizophrenia, those who received vignettes with schizophrenia were more likely to avoid prescribing efavirenz, a medication with known neuropsychiatric side effects (17.7% vs. 45.5%, p < 0.01), more likely to agree to be helped by a specialist (34.5% vs. 12.9%, p < 0.01), and more likely to recommend directly observed therapy (20% vs.10%, p = 0.01). HIV clinicians recognize the importance of recommending HAART treatment to individuals with schizophrenia and AIDS and avoid using antiretroviral medication with known neuropsychiatric side effects.
AB - Individuals with schizophrenia are at risk of developing HIV and are known to experience barriers to optimal medical care. Our goal was to determine, among a cohort of HIV clinicians, whether or not the diagnosis of schizophrenia affected the clinical decision to offer highly active antiretroviral therapy (HAART) to AIDS patients. This is a cross-sectional study of a random, national sample of HIV experts drawn from the membership of the American Academy of HIV Medicine. Participants were mailed a self-administered questionnaire with a case vignette of a new onset AIDS patient and were specifically asked whether or not they would recommend HAART treatment. Vignettes were randomly assigned to include a diagnosis of schizophrenia or not. We located 649 clinicians (93%); 347 responded (53.4%). Responders and non-responders did not differ in demographics or work characteristics. Recommendation of antiretroviral treatment did not differ between those who received a case vignette with schizophrenia versus those who did not (95.8% vs. 96.6%, p = 0.69). Compared to those who received a case vignette without schizophrenia, those who received vignettes with schizophrenia were more likely to avoid prescribing efavirenz, a medication with known neuropsychiatric side effects (17.7% vs. 45.5%, p < 0.01), more likely to agree to be helped by a specialist (34.5% vs. 12.9%, p < 0.01), and more likely to recommend directly observed therapy (20% vs.10%, p = 0.01). HIV clinicians recognize the importance of recommending HAART treatment to individuals with schizophrenia and AIDS and avoid using antiretroviral medication with known neuropsychiatric side effects.
KW - HAART
KW - HIV/AIDS
KW - Schizophrenia
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U2 - 10.1300/J005v33n01_09
DO - 10.1300/J005v33n01_09
M3 - Article
C2 - 17298934
AN - SCOPUS:33847677633
SN - 1085-2352
VL - 33
SP - 109
EP - 120
JO - Journal of Prevention and Intervention in the Community
JF - Journal of Prevention and Intervention in the Community
IS - 1-2
ER -