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January 14, 1998

AIDS Drug Regimens That Are Worth Their Costs

Author Affiliations

From the Department of Medicine, Division of General Internal Medicine and Primary Care, Long Island Jewish Medical Center, New Hyde Park, NY.

JAMA. 1998;279(2):160-161. doi:10.1001/jama.279.2.160

The American public is justifiably celebrating the recent good news that opportunistic illnesses and deaths related to acquired immunodeficiency syndrome (AIDS) declined nationwide in 1996 for the first time since the pandemic began more than 15 years ago.1 These trends reflect advances in opportunistic infection prophylaxis and highly active antiretroviral therapy and interventions to prevent transmission of human immunodeficiency virus (HIV) infection. Published guidelines have provided thoughtful distillations of complex research results for widespread clinical use.2-6 Despite this, some population groups have not benefited from the new therapies. In fact, increased incidences of AIDS-related opportunistic illnesses in 1996 were experienced by black and Hispanic men and women with heterosexual exposures.1 The disparity in opportunistic infection trends between population groups most likely reflects differences in access to the full range of new therapies now available.7 Barriers to access are depriving many patients with HIV infection of life-extending health care.