Changing attitudes towards antiretroviral treatment of HIV infection: a prospective study in a sample of Dutch general practitioners

This study investigated the attitude towards antiretroviral therapy (ART) f or HIV infection over time, in a sample of Dutch general practitioners (GPs ). Twenty-one GPs, of which 16 were practising in Amsterdam, completed mult iple questionnaires on HIV-related topics between April 1995 and March 1997 In 1995, only 10% had a positive attitude towards treatment of asymptomati c persons with a CD4 + > 300 x 10(6)/l; at the end of the study 43% had. In 1995, 57% had a positive attitude towards treatment of asymptomatic person s with a CD4 + less than or equal to 300 x 10(6)/l, and 52% towards treatme nt of symptomatic patients with a CD4 + less than or equal to 400 x 10(6)/l ; heterosexual GPs more often had a positive attitude as compared to homose xual GPs (p = 0.005 and p = 0.01, respectively). Ar the end of the study th e proportions of GPs with a positive attitude had increased from 57 to 81% and 52 to 95%, respectively. The risk of adverse effects, strict dose regim ens and medicalization were regarded as the main disadvantages of the curre nt treatment strategy. The conclusion is that the attitude towards ART has become more positive since 1995. At the beginning of 1997, however, there s till existed reservations about treatment of asymptomatic persons with CD4 + cell counts > 300 x 10(6)/l.