Factors associated with HIV-infected patients' recognition and use of HIV medications

In 1996, we interviewed 224 HIV-infected patients (54% men, 63% African American) receiving HIV medical care in St. Louis, Missouri about their recognition, prior use, and current use of HIV medications. Of 221 respondents who had heard of at least one antiretroviral drug, only 2 respondents reported they had never taken antiretroviral drugs. Multivariate logistic regression among respondents with CD4 counts <500 cells/mm3 identified sociodemographic variables (gender, race, education, and site of care) that were significantly (p < .05) associated with never having heard of, never having used, and not currently using specific antiretroviral drugs. African Americans in general, African American women, or African Americans with 12 years of schooling were more likely never to have heard of didanosine (ddI)/zalcitabine (ddC), stavudine (d4T), lamivudine (3TC), protease inhibitors, and non-nucleoside reverse transcriptase inhibitors (NNRTIs). In addition, women were more likely never to have heard of protease inhibitors, and respondents with < or = 12 years of schooling were more likely never to have heard of NNRTIs. African Americans were more likely never to have taken azidothymidine (AZT), and African American women were more likely never to have taken 3TC and protease inhibitors. Sociodemographic variables were not significantly associated with current use of specific antiretroviral drugs among those with CD4 levels <500 cells/mm3, nor with recognition, prior use, or current use of Pneumocystis carinii pneumonia prophylaxis among those with CD4 counts <200 cells/mm3. Findings indicate that, even among patients receiving HIV care, African Americans, women, and those with < or = 12 years of schooling were more likely never to have heard of and never to have used various specific antiretroviral medications. More focused efforts are needed to help patients become aware of available antiretroviral drugs and to encourage greater use of these drugs among all patients for whom the drugs are indicated.