Department of Community & Family
Medicine, University of California, San Diego, La Jolla 92093-0622.
Accidental
exposure to the blood of hepatitis B patients produced less fear than
does accidental exposure today to the human immunodeficiency virus
(HIV), even though both have an approximately equal overall risk of
death (approximately 1%). Subjects responding to hypothetical
insect-exposure and disease-exposure scenarios chose to avoid the
HIV-type risk of 1% chance of exposure/100% chance of death. Fear of
certain death seems to account for the greater concern about exposure to HIV than to
Hepatitis B.
School of Dentistry, University of Western Ontario,
London. gmccarth@julian.uwo.ca
OBJECTIVES: This study investigated dentists
refusal to treat patients who have HIV. METHODS: A survey was mailed to
a random sample of all licensed dentists in Canada, with 3 follow-up
attempts (n = 6444). Data were weighted to allow for probability of
selection and nonresponse and analyzed with Pearson's chi 2 and multiple
logistic regression. RESULTS: The response rate was 66%. Of the
respondents, 32% had knowingly treated HIV-infected patients in the last
year; 16% would refuse to treat HIV-infected patients. Respondents
reported willingness to treat HIV-infected patients (81%), injection
drug users (86%), hepatitis B virus-infected patients (87%), homosexual
and bisexual persons (94%), individuals with sexually transmitted
disease(s) (94%), and recipients of blood and blood products (97%). The
best predictors of refusal to treat patients with HIV were lack of
ethical responsibility (odds ratio = 9.0) and items related to fear of
cross-infection or lack of knowledge of HIV. CONCLUSIONS: One in 6
dentists reported refusal to treat HIV-infected patients, which was
associated primarily with respondents' lack of belief in an ethical
responsibility to treat patients with HIV and fears related to
cross-infection. These results have implications for undergraduate,
postgraduate, and continuing education.