Stigma, discrimination, and HIV/AIDS knowledge among physicians in Barbados.

OBJECTIVE: To determine the extent of clinical knowledge of HIV/AIDS that physicians in Barbados have and their attitudes towards persons living with HIV/AIDS. METHODS: In 2000 the Barbados Association of Medical Practitioners conducted a survey in order to assess its members' views on HIV/AIDS issues. Over a two-month period 203 physicians (76% of all those practicing in the country) were interviewed. The survey included physicians working in private practice and the public sector. They were surveyed individually concerning their attitudes towards counseling as well as their clinical knowledge, perception of safe practices, fear of occupational exposure, views on ethical issues, experience treating HIV/AIDS patients, and background with HIV/AIDS continuing education. RESULTS: In comparison to physicians who had graduated in later years, physicians who had graduated in 1984 or earlier had seen fewer HIV/AIDS clients, had lower levels of knowledge about the disease, were more likely to test for HIV/AIDS without informed consent, and were less likely to have ever attended a continuing education training course on HIV/AIDS. Overall, knowledge of the clinical indications of HIV/AIDS was low, and 76% of the physicians did not think they had adequate counseling skills. Over 80% of the physicians were comfortable looking after HIV/AIDS patients. While 95% of the physicians would not release HIV test results without a patient's consent, 33% would test, without consent, a seriously ill patient, and 15% would test without consent a patient upon whom they had to perform an invasive procedure if they perceived the patient to be from a high-risk population such as gay men or commercial sex workers. Only 53% of the physicians had attended an HIV/AIDS in-service training program between 1995 and 1999. CONCLUSIONS: Physician training in Barbados should focus on all aspects of HIV/AIDS care, including clinical and emotional factors. Attendance at such training should be mandatory for public sector physicians, and medical school curricula need to be examined to ensure their HIV/AIDS content is current and comprehensive.     

医务人员主动提供艾滋病转介服务状况及影响因素调查

目的 了解医疗卫生机构的医务人员主动为HIV/AIDS患者提供转介服务的现状及存在问题,探讨艾滋病转介工作开展的影响因素,为当地合理制定艾滋病防控策略提供依据。 方法 采用问卷调查的方法,2018年7－8月,在广西南宁市15个县(区)的20家医疗卫生机构249名医务人员进行面对面问卷调查,分析艾滋病转介服务的开展情况。 结果 研究对象对其发现或管理的HIV/AIDS患者均全部提供转介服务的比例为56.63%。提供转介服务的比例中,按照机构级别分析,最高是省级机构(67.12%),最低是县(区)级机构(47.46%),但差异无统计学意义(χ²=5.463,P=0.131);按照机构性质分析,最高是疾病预防控制中心(88.23%),最低是综合医院(52.24%),差异有统计学意义(χ²=7.980,P=0.046)。“医生忘记转介”是未提供转介服务的主要原因(占88.89%)。单因素分析显示,从事艾滋病防控工作年数、所在的机构性质、是否接受过艾滋病防治知识与转介工作技能培训等因素,与医务人员是否主动为发现的患者提供转介服务有统计学关联(P<0.05)。多因素分析显示,机构性质是疾病预防控制中心(OR=10.426, 95%CI: 1.745～62.294)、从事防艾工作年数为5年及以上(OR=2.598, 95%CI: 1.447～4.666)、接受过艾滋病防治知识与转介技能培训(OR=12.066, 95%CI: 4.518～32.223)是医务人员主动提供转介服务的积极因素。 结论 医务人员主动为患者提供转介服务的比例仍较低。“医生忘记转介”是未提供转介服务的主要原因。为保证艾滋病转介工作的有效开展,需建立首诊医生负责制和转介工作考核、奖励机制;同时进一步加强医务人员尤其是综合医院和从事艾滋病防控工作年数低的医务人员培训, 激励其主动为患者提供转介服务,确保HIV/AIDS患者有效管理和治疗。     

西部地区业务再培训医务人员中艾滋病知识、态度和行为调查

目的了解来自西部地区医院业务再培训的医务人员对艾滋病预防知识知晓情况,掌握医务人员对艾滋病健康教育的需求,为在医务人员中进一步开展健康教育提供依据,以提高职业防护能力。方法对282名来自西部地区各医院业务再培训的医务人员进行AIDS知识和态度调查。结果医务人员的艾滋病相关知识水平整体较高,仅1.42%的被调查人员认为看起来健康的人不会携带艾滋病病毒,但是对AIDS诊断治疗及职业防护方面的知识掌握相对较差。36.17%的医务人员既往接受过AIDS专门培训,97.52%的医务人员有接受AIDS相关知识培训需求和意愿;大多数医务人员对PLWHA持同情和理解态度,但仍有一定比例的医务人员持恐惧回避态度;77.66%的医务人员表示“不愿意”去治疗或护理PLWHA的医院或科室工作;91.13%的医务人员认为自己有“职业感染HIV的危险”。结论西部地区医务人员对PLWHA持有一定的歧视态度,而且存在有恐惧和对职业暴露感染HIV风险的担忧。因此,医务人员的AIDS相关知识有待进一步提高,应开展针对性AIDS防治知识的专门培训。     

Survey of HIV/AIDS knowledge and attitudes of Kuwaiti family physicians

OBJECTIVES: This study aimed to explore Kuwaiti family physicians' attitudes and knowledge about HIV/AIDS. METHODS: One hundred and sixty-two Kuwaiti family physicians (95 females and 67 males) from all four health catchment areas have completed a 30-item self-administered questionnaire to measure HIV/AIDS-related attitudes and knowledge. RESULTS: Knowledge was lacking in areas dealing with HIV-related neuropsychiatric complications and other issues concerning HIV/AIDS, special populations and range of normal sexuality. The majority of physicians expressed negative attitudes toward homosexuality and about AIDS patients in general. Eighty-three per cent of Kuwaiti family physicians would opt out of treating AIDS patients. More than half of the physicians would avoid coming into social contact with HIV-seropositive persons. No significant difference was found for the total knowledge and attitude scores for gender. CONCLUSION: The results of this survey revealed that even in the second decade of the AIDS epidemic, some Kuwaiti family physicians continue to have a lack of proper knowledge about HIV and harbour negative attitudes toward AIDS patients. There is a need to promote an AIDS education early in the medical internship training years which addresses many underlying socio-cultural factors.     

How are patients informed about their HIV test results?

BACKGROUND: AIDS and HIV are hot topics in public health nowadays, but little information is available about the way in which HIV test results are communicated to patients. OBJECTIVE: Our aim was to find out about the way in which patients are informed about their HIV test results and the delay they experience. METHOD: Since 1996, a representative network of sentinel GPs has recorded data about requests for HIV tests, risk factors and the way in which and the delay with which patients are informed about their HIV test results. RESULTS: Between 1996 and 1999, 4807 requests for an HIV test were recorded. Test results were given mostly by phone (41.9%). Patients at risk were informed more often during a planned follow-up. Anxious patients were informed more often about the results by phone, and in 61.2% test results were communicated during the first week following the test. Results were given earlier if patients were anxious or had themselves asked for the test. Although non-consensual HIV testing is against the European guidelines on informed consent, 102 tests (2.2%) were performed without informed consent. CONCLUSIONS: Even though notification by phone decreases the delay, physicians should be encouraged to make follow-up appointments to inform the patient about the test results. A face-to-face conversation is the only way in which physicians can offer valuable post-test counselling. Physicians should be informed about the unlawfulness of non-consensual HIV testing.     

2015年绵阳市男男性行为人群艾滋病哨点监测结果分析

摘要:目的 了解男男性行为人群（MSM）艾滋病疫情及知识知晓和性行为现状,分析艾滋病病毒（HIV）感染影响因素。方法 2015年2 - 6月,以绵阳城区MSM为对象,用滚雪球抽样法,在固定场所和知情同意下,进行调查对象招募和自填式行为学调查及血清学检测。结果 共监测436例,艾滋病知识知晓率98.4%（429/436）,近1年做过艾滋病病毒（HIV）检测并知晓结果75.0%（327/436）,近1年干预服务覆盖率92.0%（401/436）。HIV确证阳性率8.3%（36/436）,梅毒现症感染率7.6%（33/436）。多因素分析结果:高中及以上文化程度（OR=0.366,95%CI:0.146～0.918）、接受干预服务覆盖（OR=0.154,95%CI:0.056～0.427）是HIV感染保护因素,近6月无保护性男性肛交是危险因素（OR=2.924, 95%CI:1.211～7.092）（P值均＜0.05）。结论 该市MSM艾滋病知识知晓、干预服务覆盖及安全套使用率较高,HIV疫情相对低水平,但有所回升。应及时分析、解决存在不足,促进防治工作持续深入开展。     

Human immunodeficiency virus testing experience and hepatitis B vaccination and testing status of healthcare workers in South Carolina: implications for compliance with US Public Health Service guidelines.

OBJECTIVE: To assess the previous human immunodeficiency virus (HIV) testing experience and the hepatitis B (HB) vaccination and testing status of healthcare workers potentially involved in invasive surgical procedures. DESIGN: Anonymous questionnaire survey. SETTING: Tertiary care and community-teaching medical center and affiliated healthcare facilities in Greenville County, South Carolina. PARTICIPANTS: Physicians (including residents in training), dentists, nurses and surgical technicians working in the operating room and labor/delivery areas. RESULTS: Of 506 responding physicians and dentists (65% of the sample), 60% previously had had a test for HIV, and 72% had received HB vaccine. Testing had occurred most often because of a requirement by an insurance company or because of blood donation. Eighty percent of tested respondents had their most recent test within 2 years of the time of the survey (August 1991). Of 145 responding nurses and surgical technicians (73% of the sample), 26% had had a test for HIV and 77% had received HB vaccine. CONCLUSIONS: The majority of surgeons and dentists in Greenville County, South Carolina, already have been tested for HIV for a variety of reasons and thus are aware of their HIV infection status, at least as of the time of the most recent test. The majority of local healthcare workers who are potentially involved with invasive surgical procedures have received HB vaccine. Programs developed in response to recent US Public Health Service guidelines should take HIV testing of healthcare workers for any reason into consideration and should emphasize HB vaccination and testing for vaccine-induced HB immunity.     

Self-reported HIV and AIDS experience, practices, and knowledge of Pennsylvania family physicians.

BACKGROUND: Patients with disease caused by the human immunodeficiency virus (HIV), while still more commonly treated in urban settings, are being seen in nonurban areas in numbers rapidly outstripping the local availability of specialists with expertise in HIV or acquired immunodeficiency syndrome (AIDS). METHODS: A questionnaire designed to measure self-assessed experience, practices, and knowledge regarding basic aspects of HIV was mailed in 1989 to the 2177 members of the Pennsylvania Academy of Family Physicians. RESULTS: The response rate was 72 percent. Approximately 95 percent of physicians surveyed had been asked questions by patients about AIDS, 30 percent had a patient with a confirmed positive blood test, and 27 percent had a patient with symptomatic HIV disease in their practice. CONCLUSIONS: Although most family physicians indicated that they were comfortable in recognizing persons at risk, counseling, and using tests to diagnose HIV and AIDS, more than one-half reported practice patterns at variance with published guidelines. Respondents were most uncomfortable with their knowledge and skills regarding legal issues, state and community resources, and caring for patients with AIDS. Continuing medical education courses at local hospitals and written materials were the two methods of AIDS education most likely to be used by respondents.     

深圳市工厂流动人口艾滋病知识态度行为调查

目的了解深圳市工厂流动人口艾滋病相关知识、态度和行为状况,为艾滋病防治工作提供依据。方法由人力资源部门协调,根据方便抽样原则,抽取深圳市南山区马家龙工业区1家服装制造厂和1家电子晶体制造厂一线员工中全部流动人口的1/3左右员工,并使抽样人群男女比例基本持平,在征得调查对象知情同意后,发放匿名自填式问卷收集艾滋病相关知识、态度、行为以及参与健康教育活动等信息。结果共有383名被调查人员有效完成问卷。该群体总体艾滋病知识回答正确率为60.93%,＂蚊子叮咬可以传播艾滋病＂的回答错误率最高,为61.10%。艾滋病正向态度报告率为41.69%,安全套正确使用率为61.01%。最近一年接受过专门的艾滋病健康教育的工厂流动人口为35.51%,艾滋病健康教育状况与年龄分布、婚姻状态相关。想了解的艾滋病相关知识依次为传播途径（58.22%）、预防知识（44.91%）、治疗知识（37.08%）、临床表现（34.73%）、流行情况（31.07%）。工厂流动人口喜欢的健康教育方式依次为电视（55.87%）、书刊报纸（42.04%）、宣传展览（33.94%）、收音机（26.89%）、专题讲座（25.33%）。结论工厂流动人口艾滋病相关知识知晓率与正向态度报告率和行为正确率均较低。开展工厂流动人口艾滋病健康教育,应根据该人群的不同需求制定健康教育策略。     

江西省胸科医院医务人员艾滋病相关歧视及服务意愿调查

目的 调查江西省胸科医院医务人员的艾滋病相关歧视及服务意愿,并探索其影响因素。方法 采用自行设计问卷对该院526名医护人员艾滋病相关歧视及影响因素进行调查。结果 该院医务人员对艾滋病知识回答满分者占20.7%,艾滋病防治知识得分（3.65 + 1.02）分,职业防护知识得分（4.87 + 1.37）分,对艾滋病病毒感染者/患者(PLWHA)的接受程度得分（3.21 + 1.19）分,健康权利认知得分（1.79 + 0.77分）。53.1%的人会选择回避治疗或护理感染了HIV的患者。Logistic回归分析显示,社会接受程度、健康权利认知、学历和婚姻状况是医务人员为PLWHAS提供医疗护理服务意愿的影响因素。结论 江西省医务人员艾滋病相关歧视仍然存在,应加强医护人员艾滋病防治知识和职业防护技能培训。     

Who's talking? Communication between health providers and HIV-infected adults related to herbal medicine for AIDS treatment in western Uganda

Communication between patients and physicians about herbal medicine is valuable, enabling physicians to address issues of potential herb-drug interactions and ensuring appropriate medical care. As seemingly harmless herbal remedies may have detrimental interactions with various HIV antiretroviral drugs, the importance of communication is intensified, but often stifled around the use of herbal medicine in the treatment of HIV/AIDS. In western Uganda, 137 HIV-infected adults attending conventional HIV/AIDS treatment programmes (67 of whom were receiving antiretroviral therapy) shared their experiences and perceptions about traditional herbal medicine and related patient-physician communication issues through interviews and focus group discussions. Although close to 64% of respondents reported using herbal medicine after being diagnosed with HIV, only 16% of these respondents had informed their conventional medical practitioners about using these herbs. Furthermore, only 13% of antiretroviral therapy recipients had inquired about concurrent herb-antiretroviral drug use with their HIV/AIDS treatment providers, largely because they perceived a low acceptance and support for herbal medicine by conventional medical practitioners. Importantly however, almost 68% of HIV-infected adults indicated they would be willing to discuss herbal medicine use if directly asked by a conventional medical practitioner, and the overwhelming majority (91%) said they were amenable to following physician advice about herbal medicine. As such, improved patient-physician communication about herbal medicine is needed, and we recommend that herbal medicine histories be completed when patient histories are taken. Also, HIV/AIDS treatment programmes should be encouraged to develop specific patient-physician communication standards and best practice guidelines to ensure that patients can make informed decisions about herb and pharmaceutical drug co-therapy based on known risks, particularly in the case of AIDS patients receiving antiretroviral therapy. Communication about herbal medicine usage should be viewed as a timely and cost-effective component of antiretroviral therapy programmes, one which may contribute to the overall success of AIDS treatment in Africa.     

淮安市HIV/AIDS患者及其配偶艾滋病知识、态度、行为及心理状况调查

目的了解HIV/AIDS患者及其配偶艾滋病知识、态度、行为及心理状况,为开展家庭内行为干预提供依据。方法采用一对一问卷调查形式,对53对艾滋病单阳家庭中的HIV/AIDS患者及其配偶进行调查。结果艾滋病知识知晓率为85.85%,71.70%的调查对象认为艾滋病感染者身份应该保密,86.79%的HIV/AIDS患者能平静接受感染事实,有81.82%与配偶发生性行为时能坚持使用安全套。37.74%的调查对象存在抑郁症状。结论应加强艾滋病健康教育及反歧视宣传,开展关怀技能培训,为HIV/AIDS患者提供心理支持,提高生活质量。     

Patient attitudes and knowledge about HIV infection and AIDS

BACKGROUND. Family physicians are caring for an increasing number of those with human immunodeficiency virus (HIV) infection, those at risk, and those concerned about HIV disease. METHODS. A questionnaire survey of attitudes and knowledge about HIV infection was conducted in 430 patients in three family practices in Monroe County, NY. RESULTS. The majority of those surveyed had worried about catching HIV and had spoken with friends or relatives about HIV. Approximately 7.5% had had the HIV test. Approximately half of all the respondents expressed a desire to discuss HIV-related issues with their family doctor; however, less than 8% had actually done so. The majority of the respondents believed their family doctor was competent to answer questions about HIV disease. Furthermore, the majority were well informed about the modes of transmission of HIV. Many of the respondents were unsure of the lack of risk from casual contact, however, and whether acquired immune deficiency syndrome (AIDS) is incurable at the present time. CONCLUSIONS. Family physicians need to take a more active role in educating and counseling patients about HIV disease.     

Prevention practices of primary health care physicians in Switzerland in the context of the HIV/Aids epidemic: changes between 1990 and 2002

BACKGROUND: Individual preventive counseling offered to the general public by private doctors working in primary health care is an essential component of the Swiss National Aids Prevention strategy. Surveys were conducted to assess to what extent they fulfill this role and how this may have changed over time. METHODS: Three cross-sectional surveys were conducted in 1990, 1995, and 2002 by anonymous mailed questionnaire in a random sample of primary health care physicians. Dimensions of the physicians HIV prevention practices investigated were: practice of HIV risk assessment, content and frequency of HIV pretest counseling, and, in 2002 only, care of patients living with HIV/AIDS. Trends over the 12-year period were calculated; logistic regressions were performed to investigate factors associated with the frequency of counseling given to HIV positive patients. RESULTS: Risk assessment has increased dramatically over the period for certain groups of patients (patients requesting contraception, young people and new patients). In 2002, routine screening is often or always performed by 93% of physicians for intravenous drug patients or patients with a sexually transmitted infection; 77% for homosexuals; 76% for patients requesting contraception; 63% for young people. It is less frequent in other groups (migrants: 40%; separated/divorced patients: 29%). More than half of physicians care for patients with HIV. Around two-thirds of physicians regularly discuss with their HIV positive patients issues related to patients' professional, social and private life. There are few differences among specialties regarding the propensity to discuss these topics. CONCLUSION: Prevention activities by primary care physicians have increased in the last decade. Nonetheless, potential for increased prevention still exists in some areas of risk assessment and counseling.     

Prenatal HIV testing in Ontario: knowledge,attitudes and practices of prenatal care providers in a province with low testing rates

OBJECTIVE: To describe the knowledge, attitudes and practices of prenatal care providers in relation to prenatal HIV testing. METHODS: A stratified random sample of 784 family physicians, 200 obstetricians and 103 midwives providing prenatal care in 3 health planning regions in Ontario received a questionnaire. RESULTS: Response was 622/1087 (57%). Almost half of participants (43%) were not aware of Ontario's prenatal HIV testing policy. Eighty-five percent of participants reported that they offered or ordered HIV testing for all pregnant women. Sixty-six percent agreed that women should have a choice about whether to test or not, and midwives were more supportive of having an informed consent process than were physicians. CONCLUSION: Knowledge about the risks and benefits of prenatal HIV testing needs to be improved, and standards for informed consent should be re-evaluated to achieve the most ethical process with the least complexity.     

2010年桂林市孕产妇艾滋病哨点监测结果分析

目的 了解桂林市孕产妇艾滋病、梅毒、丙肝的感染情况以及艾滋病相关知识水平,为预防控制提供依据.方法 2010-04/06对初次到哨点医院的400名孕产妇进行问卷调查并进行HIV、丙型肝炎和梅毒抗体检测.结果 检测对象艾滋病防治知识的8道核心问题知晓率(至少答对6道题)为57.0％,HIV抗体阳性率为0.25％(10/400),梅毒抗体(RPR)阳性率为0.25％ (1/400),未检出丙肝阳性.结论 桂林市孕产妇艾滋病知识知晓率较低,建议加强婚前HIV检测和孕期HIV检测,预防母婴传播.     

南京市医务人员性病／艾滋病专业知识调查

目的 了解南京市医疗机构开展性病/艾滋病培训的情况及医务人员掌握性病/艾滋病知识的现状，方法 对南京市57家区县级以上医疗机构的医务处负责人进行问卷调查。了解他们开展性病/艾滋病培训的情况；对南京市区、郊区43所医疗机构的562名医务人进行问卷调查。了解他们的性病/艾滋病知识，结果 1996-1999年间，被调查的57家医疗机构中，13家（22.6%)开展过性病/艾滋病教育；14.9%(84/562)的被调查医务人员接受过培训；被调查医务人员的性病/艾滋病知识平均分数为59.8分。医务人员知识水平的高低与所在医疗机构的级别及他们的职称、专业、是否诊治过性病/艾滋病患，是否接受过培训有关。结论 南京的医疗机构中仅一小部分开展过性病/艾滋病教育，医务人员的性病/艾滋病知识水平仍较低，对他们的教育必须加强。。     

HIV阳性结果告知对男男性行为者高危性行为的影响

目的了解HIV阳性结果告知对男男性行为者(MSM)行为改变的影响。方法 2011年1月-2012年12月,对1 365名MSM进行问卷调查和梅毒快速血浆反应素环状卡片试验(RPR)、梅毒螺旋体血球凝集试验(TPPA)、艾滋病病毒(HIV)抗体初筛检测及确认,对121名HIV确认阳性者进行规范面对面告知,6个月后对纳入研究的HIV阳性者进行随访,比较阳性结果告知前后艾滋病(AIDS)知识知晓、高危性行为特征及性病感染情况。结果 79名MSM完成随访,阳性结果告知后51.9%的感染者减少了肛交行为,49.4%的减少了性伴数,55.7%的在性行为时安全套使用率提高,告知前后肛交行为、多性伴、不使用安全套等高危性行为发生率,差异均有统计学意义(P0.05)。结论阳性结果告知能有效降低MSM人群高危性行为发生率,应加强告知的规范性,确保告知的效果。     

安徽省2008年暗娼人群艾滋病监测分析

目的研究安徽省暗娼人群HIV感染状况及其态度行为特征,为安徽省艾滋病预防和控制及效果评价提供依据。方法对暗娼人群进行问卷调查,同时采血做艾滋病病毒（HIV）抗体检测、梅毒RPR试验。结果共监测4 584位监测对象,发现HIV阳性者1例（阳性率为0.02%）。梅毒RPR试验105人呈阳性（2.29%）。结论目前安徽省暗娼人群HIV感染处于较低水平,暗娼人群存在安全套使用率低等多种危险行为。应对该人群加强教育和行为干预,消除危险因素,防止HIV传播。     

潍坊市医务人员预防艾滋病知识态度与行为调查

目的了解医护人员对艾滋病认知状况,为防治艾滋病的培训提供依据。方法对潍坊市中心城区不同级别医院1116名医务工作者采取随机问卷调查。结果各职业医务人员对艾滋病主要传播途径、一些非艾滋病传播途径及其他一般性问题认识清楚,但知识掌握不够深入和全面,对艾滋病病人或感染者不歧视,但普遍存在恐惧心理,且可能影响到提供正常的医疗服务。不同医院及同一医院不同科室人员对艾滋病的防治知识的掌握程度和态度不一致。结论医务人员对艾滋病防治的认识有待进一步提高,应结合其职业特点,进行分专业、分期分批、有目的培训,端正对艾滋病病人或感染者的态度。