Physicians' attitudes, beliefs, and practices regarding AIDS health care promotion

Article Abstract:

The AIDS epidemic has shown that health education can modify behaviors that carry high risk of promoting disease, but what the physician's role is and could be in promoting healthy behaviors is not clear. Doctors are in a unique position to counsel their patients on healthy practices and should be able to elicit sensitive information with the patient's understanding that the information will be kept confidential. To assess physicians' knowledge and practices in promoting AIDS education, a survey of 300 physicians attending AIDS-related educational courses was conducted. The doctors believed that certain health practices were more important in avoiding illness than others. They included three AIDS-related behaviors in their lists, such as avoiding multiple sexual partners, both homosexual and heterosexual, and avoiding intravenous drug use, along with avoiding smoking, eating a low-cholesterol diet and using a seat belt when driving. However, while over 70 percent of the doctors routinely query their patients about smoking, alcohol, and drug use, only 25 percent routinely asked about AIDS-related health behaviors. The physicians recommended several areas in which assistance in health promotion might be useful, such as where to refer patients for counselling, where to obtain literature for their patients, and continuing medical education courses on AIDS. The physicians surveyed were from northern Ohio, an area where AIDS is uncommon. Those doctors who had ever diagnosed an AIDS-related illness were found to be more likely to include questions about AIDS risk factors in their history-taking. One reason some physicians have difficulty in obtaining AIDS risk histories is that many physicians have difficulty in taking sexual histories in general, and in particular, in asking questions about homosexuality. Other studies have shown that up to 69 percent of homosexual patients have had to tell their doctors that they were homosexual; their doctors had generally never asked. The survey concluded that doctors believe that AIDS-related health promotion is useful, but they have yet to incorporate that into their practices. (Consumer Summary produced by Reliance Medical Information, Inc.)

Services, Study and teaching

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Attitudes: physicians, AIDS, and the American Public

Article Abstract:

This commentary by a former member of the President's Commission on Human Immunodeficiency Virus Epidemic discusses the attitudes of physicians caring for patients infected with the human immunodeficiency virus (HIV). The attitudes of all medical personnel regarding people with HIV infections parallel those of society. Poor attitudes stem from the unattractive characteristics of the patient population: drug addiction, promiscuous sexual behavior, and homosexuality, compounded by poverty, insurance and legal issues. In the January 1990 issue of Archives of Internal Medicine, Somogyi et al. report on physician attitudes towards treating AIDS patients. The three issues surrounding adverse attitudes were aversion to patients, professional isolation and patient liability. Fortunately, antipathy for patients and fear of AIDS patients did not interfere with the physicians' willingness to treat infected patients. Only 12 healthcare workers were exposed to HIV-infected blood at work and fewer than six became positive for HIV. At the same time, public attitudes towards physicians have deteriorated. It is argued that today's applicants to medical school, although adept at the basic sciences, lack the intuition, devotion to others and basic human skills needed to be a good doctor. Physicians, the American public and members of the government should address the problems of AIDS treatment together. The American Medical Association's position is that it is unethical and immoral to refuse treatment to AIDS patients. To regain the respect from the American public, physicians need to act more intelligently, morally and responsibly towards patients. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Public opinion, editorial, AIDS phobia

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Attitudes toward the care of patients with acquired immunodeficiency syndrome: a survey of community internists

Article Abstract:

Physician attitudes towards the care of patients with the acquired immunodeficiency syndrome (AIDS) are reviewed. As the AIDS epidemic increases, care previously concentrated in municipal hospitals will extend to community-based hospitals. Attitudes towards the care of AIDS patients were surveyed among 230 physicians servicing a community hospital in New York City. Of the 139 physicians responding to the survey, one third said they would not accept any more patients with AIDS. The three issues surrounding adverse attitudes were aversion to patients, professional isolation and patient liability. The greatest difference between physicians who did and did not treat AIDS patients was the physician's attitudes towards patient liability. Difficulty in finding staff and consultants willing and prepared to work with AIDS patients was a contributing factor. Community resources were inadequate. Physicians were not as concerned with aversion to and fear of AIDS as they were with financial burdens imposed by insurance required when caring for private healthcare consumers. Reimbursement, education and support teams were more of a concern to primary care physicians than to specialists in the field. Improving resources for use by community physicians is suggested. (Consumer Summary produced by Reliance Medical Information, Inc.)

Practice, Surveys, Community health services, Community medicine

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