Evidence map›Paper›PMID 26385993›Full record

ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2016

Diffusion of Newer HIV Prevention Innovations: Variable Practices of Frontline Infectious Diseases Physicians.

Douglas S Krakower, Susan E Beekmann, Philip M Polgreen, Kenneth H Mayer

Open access · bronzeAbstract read
In one paragraph

Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed, 1 pooled it
3.7field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

28 citing papers in PubMed, 1 synthesis or guideline pooled it, 37 citations in OpenAlex.

  1. Pooled it
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  10. US Guideline Criteria for Human Immunodeficiency Virus Preexposure Prophylaxis: Clinical Considerations and Caveats.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2019
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  15. Belief in Treatment as Prevention and Its Relationship to HIV Status and Behavioral Risk.Journal of acquired immune deficiency syndromes (1999) · 2018
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 2 countries.

Douglas S KrakowerDivision of Infectious Diseases, Beth Israel Deaconess Medical Center.
Susan E BeekmannDepartments of Internal Medicine.
Philip M PolgreenDepartments of Internal Medicine.
Kenneth H MayerDivision of Infectious Diseases, Beth Israel Deaconess Medical Center.
Fenway Health · USHadassah Medical Center · ILUniversity of Iowa · US

Funding

The impact of HIV viral diversity and cellular immunity on HIV pathogenesisP30AI060354 · NIAID · HARVARD UNIVERSITY (MEDICAL SCHOOL) · PI ROBERT A. PARKER · 2004 to 2026
$94.4M
Optimizing HIV Pre-Exposure Prophylaxis through Shared Decision MakingK23MH098795 · NIMH · BETH ISRAEL DEACONESS MEDICAL CENTER · PI KRAKOWER, DOUGLAS SCOTT · 2012 to 2016
$873k
NCEZID CDC HHS FOA CK11-1102NIAID NIH HHS P30 AI060354NIMH NIH HHS K23 MH098795
6 · The paper itself

Abstract

backgroundUS Public Health Service guidelines recommend early initiation of antiretroviral treatment (ART) for human immunodeficiency virus infection (HIV)-infected patients and preexposure prophylaxis (PrEP) as a prevention option for persons at risk for HIV acquisition. Before issuance of these guidelines, few clinicians reported prescribing early ART or PrEP.

methodsThe Emerging Infections Network, a national network of infectious diseases physicians in the United States and Canada, was surveyed in September 2014 to assess practices of adult HIV-care providers with early ART, PrEP, and other guideline-recommended HIV prevention methods.

resultsAlmost half of the 1191 active members invited (48.1%) participated; 415 (72.4%) were HIV-care providers. Most providers (86.5%) indicated that they typically recommended ART initiation at diagnosis, irrespective of CD4(+) cell count. However, for patients with a CD4(+) cell count >500/µL, clinicians would defer ART if patients did not feel ready to initiate ART (94.7%) or had uncontrolled substance abuse (66.0%). Many providers had counseled HIV-infected patients about PrEP for partners (59.0%) or offered visits for partners to discuss PrEP (40.7%), and 31.8% had prescribed PrEP. Clinicians who deferred ART were less likely to endorse and engage in aspects of PrEP provision.

conclusionsConcordant with guidelines, most infectious diseases physicians recommend early ART, and many have experience with aspects of PrEP provision, suggesting recent evolution of clinician practices. Providers who defer ART are also cautious about PrEP. Interventions that help physicians motivate patients to initiate ART and identify missed opportunities to provide PrEP could enhance HIV prevention.

Indexed as

Infectious Disease MedicineAnti-Retroviral AgentsCanadaCross-Sectional StudiesHIV InfectionsHumansPhysiciansPractice Guidelines as TopicPractice Patterns, Physicians'Surveys and QuestionnairesUnited StatesAnti-Retroviral Agentsearly antiretroviral treatmenthealthcare providerHIV preventionpreexposure prophylaxis

Identifiers

PMID26385993
PMCPMC4678105
OpenAlexW2223492615

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.