Attention HIV doctors: You’re doing a good job 

Study finds racial differences in responses 

HIV patients surveyed about their medical care reported overall satisfaction, although many continued to experience side effects, a new study reports.

"They still said they were satisfied with their treatment and care and the physicians’ decisions," says Jeffrey Smith, director of clinical research at the American Foundation for AIDS Research (amFar) in New York City.

Even the 3% of the 490 patients surveyed who reported that their overall health had gotten worse since initiating antiretroviral medication appeared to be satisfied with their medical care, he notes.

Among that group, 77% reported excellent or good medical care, Smith adds. "They were able to separate what they experienced from antiretroviral drugs and overall health from how they perceived the physicians treating them."

The ratings from HIV patients were very positive for physicians.

Liking their doctors 

"We wanted to see if they thought their physicians were experienced enough to provide good medical care, and 89% reported they felt their overall medical care was excellent or very good," Smith says. "And another 88% reported their physicians were very knowledgeable about HIV."

About 14% of the people who completed the survey were antiretroviral naïve, so investigators studied the difference between that group and those who were on antiretroviral regimens to see if there was any difference in how they reported their satisfaction with medical care, and there was no difference, he explains.

The main reason reported by patients who were not on an antiretroviral regimen — their decision was based on a recommendation by their physician, Smith notes. "The take-home message for physicians is they know what they’re doing, prescribing to people who need the drugs and not to the people who don’t."

There were significant differences between ethnic groups with regard to improvements in overall health. The survey had been administered in both English and Spanish.

For example, 77% of Hispanics and 67% of African Americans, compared with 57% of whites reported an improvement in their overall health after initiating antiretroviral therapies, Smith adds.

"That was interesting because there’s this whole idea that African Americans are not willing to take antiretroviral drugs, but our surveys showed that once blacks took the drugs they were significantly happier than whites," he says.

Also, significantly more blacks and Hispanics than whites reported not being sexually active, and significantly more respondents, age 50 and older, abstained from sex when compared with other age groups, Smith says. "And significantly more women than men reported they were not sexually active."

Who’s using condoms? 

"The other thing that struck me as interesting was that 67% of Hispanics and 53% of blacks reported always using a condom, compared with 39% of whites," he points out. "Those were both statistically significant compared to whites."

Investigators also found that patients were more receptive to taking some of the newest drugs, including those that required injections, than their physicians might believe, Smith says.

"Physicians say patients don’t want to take that two-injections-a-day drug until the last moment, but patients say they don’t mind if it’s their best hope until the next treatment comes in," he says.

"Over the years, patients have gotten more involved in their medical care decisions," Smith adds. "They may not be community activists, but for these types of chronic diseases that impact life so much, the patient has to be involved."