ObjectiveTo assess rates of prescriptions of protease inhibitors (PI) and determinants of not being prescribed PIs in a cohort of HIV-infected people eligible (according to published guidelines) for highly active antiretroviral therapy (HAART).DesignCross-sectional survey.MethodsA total of 684 patients with CD4+counts <500 cells/&mgr;l were enrolled from seven Italian HIV treatment centers from October 1997 to April 1998. A questionnaire on health-related quality of life (MOS-HIV) and patient ratings of the quality of care was administered. Sociodemographic variables, HIV disease-related factors, and prescribed antiretroviral therapy were also recorded.Results61% of those enrolled were prescribed PI (median, 7.5 months). In addition, 75% of patients had previously received antiretroviral therapy. Fewer than 1% were prescribed nonnucleoside reverse transcriptase inhibitors (NNRTIs). Using multivariable logistic regression considering those with CD4+counts <500 cells/&mgr;l, patients reporting the least information received (odds ratio [OR], 1.78; 95% confidence interval [CI], 1.23–2.58), injecting drug users (IDUs; OR, 1.73; 95% CI, 1.18–2.54), people with CD4+counts >200 cells/&mgr;l (OR, 1.76; 95% CI, 1.19–2.61), and patients with early stage disease (OR, 2.24; 95% CI, 1.73–2.90) were less likely to have be prescribed PIs.ConclusionsOf patients eligible for HAART, only 61% were prescribed PIs. People who wanted more information, IDUs, and patients in earlier disease stages are significantly less likely to be prescribed PIs. Access to HAART remains a critical issue in the management of HIV disease.