OBJECTIVES: To analyze how newly HIV+ diagnosed patients are managed in 3 French HIV Public Hospitals. METHODS: STAR is an observational study designed to prospectively collect electronic data on immunological and virological status, anti-retroviral therapy (ART) and medical cost of HIV+ patients. Newly diagnosed (de novo) patients are exhaustively included in the cohort since February 2002 in order to identify therapeutic strategies in the setting of clinical practice. RESULTS: At the end of March 2003, a total of 328 de novo patients (65% male) were included, of mean age 36.8±10.5 years, mainly infected through sexual contacts (49% heterosexual and 27% homosexual). At the time of HIV diagnosis, mean CD4 counts and viral load were respectively 368±278 /mm3 and 111947±164986 copies/ml. Fifty five patients (17%) had already clinical AIDS status and the mean time from seropositivity was 248±104 days. In March 03, 59.5% of patients were without ART (among whom 94.4% were totally ART-naïve), 36% were treated with a combination of 3 anti-retrovirals and 4% with 4 anti-HIV drugs. The most frequent combinations were 3 NRTIs (38%) and 2 NRTIs + 1 boosted Protease Inhibitor (29%). The mean time between HIV diagnosis and initiation of ART was 66±72 days and the mean duration of follow-up of non-treated patients was 237±107 days. During the observation period, 29.2% of treated patients had their treatment changed at least once, mainly because of drug-related intolerance. A total of 38% remained under the same ARV combination but changed at least one molecule. CONCLUSION: These findings obtained after 14 months showed significant trends in the management of newly HIV+ diagnosed patients with a large majority of patients without ART, a high diversity of initial ART regimens and a high frequency of early interruption.