Open AccessFrench HIV Experts on Early Antiretroviral Treatment for Prevention
Author(s) -
Bertrand Lebouché,
Kim Engler,
Joseph Josy Lévy,
Norbert Gilmore,
Bruno Spire,
Willy Rozenbaum,
Tinhinane Lacene,
JeanPierre Routy
Publication year - 2013
Publication title -
journal of the international association of providers of aids care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.813
H-Index - 31
eISSN - 2325-9582
pISSN - 2325-9574
DOI - 10.1177/2325957413488196
Subject(s) - candidacy , treatment as prevention , preparedness , antiretroviral therapy , medicine , antiretroviral treatment , human immunodeficiency virus (hiv) , legitimacy , population , family medicine , environmental health , political science , viral load , politics , law
Early use of highly active antiretroviral treatment (ART) in people living with HIV for HIV prevention has gained legitimacy but remains controversial. Nineteen French HIV experts with diverse specializations (over half of whom were clinicians) were qualitatively interviewed on their views about ART irrespective of CD4 count of more than 500 cells/mm 3 for purposes of HIV prevention, which is not systematically recommended in France. Content analysis identified 2 broad categories: individual considerations (subcategories: patient health and well-being; patient preparedness and choice) and collective considerations (subcategories: HIV transmission risk; impact on the epidemic; cost). Uncertainty surrounded many experts’ considerations, and unity was lacking on key issues (eg, candidacy for early preventive treatment, expected clinical- and population-level effects). An umbrella theme labeled “Weighing the merits of early ART in the face of uncertainties” was identified. Our analyses raise doubts about the current acceptability of widespread implementation of early ART for HIV prevention in France.