The implementation of the DHHS Guidelines for the use of antiretroviral agents in HIV-infected adults: a pilot study

The objective of this study was to assess whether United States DHHS guidel ines for treatment with antiretroviral therapies are being implemented by h ealth care providers when discussing treatment options with newly diagnosed I;HIV patients. Health care providers were observed interacting with HIV p atients while making decisions about treatment. Observers assessed whether providers and patients discussed the Jive benefits and six risks of initiat ing antiretroviral therapy, as recommended in the DHHS Guidelines. Prelimin ary results indicate that the DHHS Guidelines are not being implemented in the way they were intended. The risks and benefits of antiretroviral therap y were infrequently discussed. No more than four of the II risk/benefit ite ms were discussed with any patient, and four of the six risk items were nev er mentioned to any patient. Potential reasons why the guidelines are not b eing implemented are discussed.