What risk of death would people take to be cured of HIV and why? A survey of people living with HIV

Benjamin R Murray; Allison Kratka; Karen A Scherr; Nir Eyal; Jennifer Blumenthal-Barby; Kenneth A Freedberg; Daniel R Kuritzkes; James K Hammitt; Regina Edifor; Madelaine N Katz; Kathryn I Pollak; Brian J Zikmund-Fisher; Scott D Halpern; Mary C Barks; Peter A Ubel

What risk of death would people take to be cured of HIV and why? A survey of people living with HIV

J Virus Erad. 2019 Apr 1;5(2):109-115.

Authors

Benjamin R Murray¹, Allison Kratka¹, Karen A Scherr^{1

2}, Nir Eyal³, Jennifer Blumenthal-Barby⁴, Kenneth A Freedberg^{3

5

6}, Daniel R Kuritzkes^{6

7}, James K Hammitt^{3

8}, Regina Edifor⁹, Madelaine N Katz^{2

10}, Kathryn I Pollak^{1

11}, Brian J Zikmund-Fisher^{12

13}, Scott D Halpern¹⁴, Mary C Barks^{2

10}, Peter A Ubel^{1

2

10}

Affiliations

¹ Duke University School of Medicine, Durham, NC, USA.
² Duke University Fuqua School of Business, Durham, NC, USA.
³ Harvard TH Chan School of Public Health, Boston, MA, USA.
⁴ Baylor College of Medicine, Center for Medical Ethics and Health Policy, Houston, TX, USA.
⁵ Medical Practice Evaluation Center, Divisions of General Internal Medicine and Infectious Diseases, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
⁶ Harvard Medical School, Boston, MA, USA.
⁷ Division of Infectious Diseases, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
⁸ Toulouse School of Economics, University of Toulouse Capitole, Toulouse, France.
⁹ University of Massachusetts Medical School, Worcester, MA, USA.
¹⁰ Duke-Margolis Center for Health Policy, Duke University, Durham, NC, USA.
¹¹ Population Health Sciences, Cancer Control and Population Sciences, Duke Cancer Institute, Durham, NC, USA.
¹² Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA.
¹³ Center for Bioethics and Social Sciences in Medicine, University of Michigan School of Medicine, Ann Arbor, MI, USA.
¹⁴ Departments of Medicine and Medical Ethics in Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.

PMID: 31191914
PMCID: PMC6543487

Abstract

People living with HIV (PLWHIV) can reasonably expect near-normal longevity, yet many express a willingness to assume significant risks to be cured. We surveyed 200 PLWHIV who were stable on antiretroviral therapy (ART) to quantify associations between the benefits they anticipate from a cure and their risk tolerance for curative treatments. Sixty-five per cent expected their health to improve if cured of HIV, 41% predicted the virus would stop responding to medications over the next 20 years and 54% predicted experiencing serious medication side effects in the next 20 years. Respondents' willingness to risk death for a cure varied widely (median 10%, 75th percentile 50%). In multivariate analyses, willingness to risk death was associated with expected long-term side effects of ART, greater financial resources and being employed (all P < 0.05) but was not associated with perceptions of how their health would improve if cured.

Keywords: HIV; medication; risk taking; treatment.

Publication types

Editorial

Abstract

Publication types

Grants and funding