Therapy naivete in the era of patent antiretroviral therapy

Antiretroviral therapy (ART) use was examined in a cohort oh homosexual men infected with HIV-1 for long periods. Multivariate logistic regression mod els, stratified by clinical indication (below and above 500 CD4 cells/mul o r prior AIDS), were used to determine predictors of ART naivete. Of the 673 men seen at visit 28 (10/97-4/98), 89 (13.2%) never used ART and 548 (81.4 %) were current users; 55% of the therapy-naive were ART eligible. Lower CD 4 cell counts predicted (P < .001) ART use. Determinants of therapy naivete differed by clinical indication. African-American race and no prior ambula tory visit predicted (P < .05) ART naivete in men with greater than or equa l to 500 CD4 cells/mul. Among those with clinical indications, less educati on, younger age, multiple sexual partners, and no prior ambulatory visit si gnificantly predicted ART naivete. In this era of effective ART, use was no t universal. Besides disease markers, these nonclinical determinants need t o be considered for promoting population therapy effectiveness. (C) 2001 El sevier Science Inc. All rights reserved.