Zala C, Montaner JS, Phillips P, Craib KJ, Strathdee SA, Schechter MT, O'Shaughnessy MV; International Conference on AIDS.

Int Conf AIDS. 1994 Aug 7-12; 10: 244 (abstract no. PB0406).

BC Centre for Excellence in HIV/AIDS, NIIRDP, Vancouver, Canada.

OBJECTIVE: To assess the impact of feedback on the level of compliance with guidelines for the prevention of specific respiratory diseases within a cohort of gay men. METHODS: We identified HIV+ men in the Vancouver Lymphadenopathy-AIDS Study cohort who completed 4 annual visits during the period 10/89 to 12/93, and who were AIDS-free as of 12/93 (n = 154). HIV- men who completed visits during the same period served as a comparison group (n = 169). Information about the use of purified protein derivative testing (PPD); history of pneumoccocal vaccinations (PV), influenza vaccinations (FV) and PCP prophylaxis during the prior year was obtained for each subject. Data regarding CD4 counts were collected at the same time. Information regarding PV and FV was available for the years 1992/93. Feed back information regarding the level of compliance with the guidelines was provided to treating physicians between 1992 and 1993. RESULTS: In the last 2 years respectively, PPD testing was done in 51% and 65% of HIV+ subjects compared to 21% and 40% of HIV- subjects. Although PPD was more frequently used among HIV+ subjects in both years (p < .001), a significant increase was present in both serologic groups (p < 0.01). In the last 2 years respectively, PV was given to 23% and 67% of HIV+ subjects compared to less than 1% of HIV- subjects (p < 0.001). FV was given to 78% and 92% of HIV+ subjects and 27% and 30% of HIV- subjects (p < .001). In the last 2 years, primary PCP prophylaxis use increased (p < 0.05) from 72% to 88% among subjects with CD4 < 200/mm3; from 52% to 63% in those with CD4% < 20% and from 53% to 64% in subjects with either CD4 < 200/mm3 or CD4% < 20%. CONCLUSION: Our data demonstrate a significant increase in the level of compliance with guidelines for the prevention of specific respiratory diseases within our cohort. This may be due, in part, to feedback provided to treating physicians during this interval. Compliance with guidelines may be much lower outside the context of this cohort study which involves highly experienced treating physicians.

Publication Types:

• Meeting Abstracts

Keywords:

• Acquired Immunodeficiency Syndrome
• CD4 Lymphocyte Count
• Cohort Studies
• HIV Infections
• HIV Seropositivity
• Homosexuality
• Homosexuality, Male
• Humans
• Male
• Patient Compliance
• methods
• therapy

Other ID:

• 94369875

UI: 102208705

From Meeting Abstracts