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) for HIV infection over time, in a sample of Dutch general practitioners (GPs). Twenty-one GPs, of which 16 were practising in Amsterdam, completed multiple questionnaires on HIV-related topics between April 1995 and March 1997. In 1995, only 10% had a positive attitude towards treatment of asymptomatic 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 persons with a CD4+ < or = 300 x 10(6)/l, and 52% towards treatment of symptomatic patients with a CD4+ < or = 400 x 10(6)/l; heterosexual GPs more often had a positive attitude as compared to homosexual GPs (p = 0.005 and p = 0.01, respectively). At the end of the study the 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 regimens and medicalization were regarded as the main disadvantages of the current treatment strategy. The conclusion is that the attitude towards ART has become more positive since 1995. At the beginning of 1997, however, there still existed reservations about treatment of asymptomatic persons with CD4+ cell counts > 300 x 10(6)/l