July 18, 2006 (AIDSmeds)—HIV-positive people and their doctors agree that anti-HIV drug resistance is one of the most challenging issues in HIV care today. However, their
degree of concern is dramatically different, according to a survey
commissioned by the American Academy of HIV Medicine (AAHIVM).
According
to the survey, involving 400 HIV-positive adults and 385 doctors who
practice in the United States, nearly twice as many doctors were
“extremely” or “very” concerned about HIV drug resistance (91%) as
people living with HIV (54%). The survery also revealed a gap in HIV
patients’ perceived knowledge versus actual understanding of drug
resistance, highlighting the need for increased doctor-patient
communication and consumer-friendly education tools to help patients
better understand the potential impact of HIV drug resistance on their
overall health.
While recent surveillance data are not
available, an earlier estimate suggests that 76% of HIV-infected
individuals failing treatment in the United States have a virus that is
resistant to at least one anti-HIV medication, according to a study
published in a July 2004 issue of AIDS.
“While great
strides have been made in HIV therapy, resistance to anti-HIV
medications continues to be one of the most significant challenges
facing patients and physicians today,” said Dr. Howard Grossman,
Executive Director of AAHIVM (and Medical Editor of this website).
“Everyone living with and affected by HIV should be concerned about
drug resistance and aware of current strategies to minimize and manage
its development, such as adherence to treatment regimens, use of
resistance testing to help select the most active (or sensitive)
regimen and selection of agents with a high genetic barrier to
resistance. Ongoing patient-physician communication and education are
both essential to successful implementation of these strategies.”
The
disparity in the level of concern about HIV drug resistance between
patients and doctors may partially be attributed to patients
overestimating their level of knowledge about this issue. While 61% of
patients say they are knowledgeable about HIV drug resistance, nearly
half (45%) of those whose virus has developed resistance do not know to
which class of drugs their virus is resistant. In addition, 59% of
patients have never been told or are unsure if their virus has
developed resistance to any anti-HIV medications.
Survey
findings show that more patient-friendly language and a wider array of
resources may be necessary to help close the gap in patient knowledge
of HIV drug resistance. Sixty-five percent of patients say their
doctors are their primary source of drug resistance information. HIV
magazines (11%), the Internet (10%), and AIDS Service Organizations
(ASOs) (6%) are also cited as information resources. However, half of
physicians (51%) do not display educational materials about drug
resistance in their office, and 77% of patients agreed that some of the
terms physicians use to explain resistance are difficult to understand.
Nearly two out of three patients (64%) also noted that they were
interested in learning more about new treatment regimens, particularly
patients who are “extremely” or “very” concerned about resistance (76%).
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