USE OF PREVENTIVE INTERVENTIONS BY PERSONS INFECTED WITH TYPE-1 HUMAN-IMMUNODEFICIENCY-VIRUS (HIV-1)

Measures aimed at preventing complications and slowing progression of type-1 human immunodeficiency virus (HIV-1) can potentially reduce mor bidity. Although little is known about the use of such measures, such data are critical for program planning. This study was performed to qu antify the frequency and patterns of use for such interventions. We en rolled 1,171 persons infected with HIV, but without an acquired immuno deficiency syndrome (AIDS) defining diagnosis, in a multicenter prospe ctive study of the pulmonary complications of HIV infection. Participa nts were homosexual/bisexual men, injection drug users (IDUs), or fema le sexual contacts of HIV-infected men. Centers were university-based and geographically dispersed across the United States. Standardized qu estionnaires were administered on entry and at three-month or six-mont h intervals; we correlated use of general and HIV-related preventive m easures before entry and during the first three years in study with cl inical/epidemiologic characteristics. Overall use of preventive interv entions was low; only one third of study entrants had used such measur es. Use was greatest among those with advanced HIV infection, but only half used preventive measures on entry; IDUs were less likely than ho mosexuals to use these services. Although use of interventions such as anti-Pneumocystis and antiretroviral agents increased during study pa rticipation, general measures such as pneumococcal vaccine and tubercu losis prophylaxis were used by less than 30% of those eligible for use . Among IDUs, cumulative use of these measures remained below 20% duri ng the first three years of this study. We conclude that HIV-infected persons underuse preventive interventions, particularly general measur es. Although IDUs are especially unlikely to receive preventive interv entions, homosexual/bisexual men and female partners also appear to un deruse preventive measures. Strategies for enhancing the use of preven tive intervention are needed.