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.     

Orthopedic surgeons' attitudes and practices concerning treatment of patients with HIV infection

Concern regarding an occupational risk of acquiring human immunodeficiency virus (HIV) infection may influence surgeons' willingness to operate. A questionnaire survey of all orthopedists in the five cities with the most cases of acquired immunodeficiency syndrome (AIDS) was conducted to assess attitudes and practices. Questionnaires were completed anonymously by 325 of 510 orthopedists. In the previous year, 43 percent had examined or operated on an HIV-infected patient, and at least 90 percent who had had an opportunity to operate on an HIV-infected patient had chosen to do so. Decisions to operate did not appear to be based on hospital requirements, perceived ethical obligations, or knowledge of HIV transmissibility. Most orthopedists (85 percent) claimed the right to order preoperative HIV testing of high-risk patients, but such testing was ordered infrequently. Although most orthopedists believed they could not be compelled to operate and that ethically they could refuse when their health was threatened, they almost always were willing to treat HIV-infected patients.     

Changing treatment regimens for HIV infection: impact on referral patterns and training needs of family physicians

BACKGROUND: New antiviral medications and laboratory testing have revolutionized the care of patients infected with the human immunodeficiency virus (HIV). The development of complex treatment regimens has intensified debate about whether care should be restricted to experts in HIV care. Few studies detail how these new treatment regimens are affecting family physicians' desire to continue providing care or need for additional training. METHODS: A questionnaire eliciting personal, training, and practice demographics and attitudinal information was distributed to family physicians attending the 1996 Scientific Assembly of the American Academy of Family Physicians who completed an HIV continuing education workshop. RESULTS: The questionnaires were completed by 202 family physicians from 48 states. More than 60 percent had received training or had practiced in states with a high rate of HIV, and 143 (70 percent) had cared for at least 1 HIV-infected patient in the previous 6 months. Ninety-five percent did not expect to curtail their provision of care and believed that family physicians should become more active in the care of HIV-infected patients. Medical journals were the most requested format for ongoing education in this area, with combination antiviral therapy and new staging laboratory tests the most requested topics. CONCLUSION: The recent changes in HIV care regimens did not appear to have a major impact on family physicians' desire to continue to provide care for HIV-infected patients. Professional societies responsible for certification and continuing education might be interested in additional surveys to validate these results among larger samples nationwide.     

Drug users' AIDS-related knowledge, attitudes, and behaviors before and after AIDS education sessions

The investigators interviewed 100 drug users in a detoxification facility before and after they received information about acquired immunodeficiency syndrome (AIDS) and human immunodeficiency virus (HIV). The drug users already had a considerable amount of information about AIDS and HIV transmission modes before they received the information. However, 79 percent of them reported never having used condoms. Fifty percent of intravenous drug users acknowledged having shared needles during the previous year. Subjects exhibited psychological denial in appraising the riskiness of their personal sexual and needle-sharing behaviors, which they rated as less risky than those activities in general. Following their participation in an AIDS and HIV education program, their knowledge concerning modes of transmission and disease progression increased. Subjects became more aware of their personal risk for HIV infection, and their faith in condom effectiveness and their intent to use them increased. Intravenous drug users reported increased determination to stop their drug use. The results suggest that AIDS education efforts can be useful in programs to help prevent HIV transmission among drug users.     

AIDS in California family medicine. Changing experiences, knowledge, and geographic distribution

Information regarding practice patterns specific to acquired immunodeficiency syndrome (AIDS) was obtained in 1988 from 1774 family physicians in California using a mail survey. Data were analyzed across the following county groupings: Los Angeles County, other counties in standard metropolitan statistical areas, and counties outside standard metropolitan statistical areas. Comparisons were made with the data from a telephone survey conducted in 1986. Differences over time were analyzed. By 1988, the percentage of physicians treating or referring patients for possible AIDS had more than doubled in counties outside standard metropolitan statistical areas. The percentage of physicians reporting one or more diagnosed cases of AIDS had tripled, a finding that suggests the importance of AIDS in family medicine is increasing at a rapid rate. In addition, survey results indicate that a majority of those surveyed still lack the AIDS-related knowledge and competency necessary to effectively deal with AIDS.     

Sexual practices and AIDS knowledge among women partners of HIV-infected hemophiliacs.

About 12 percent of the women sex partners of hemophilic men who are seropositive for the human immunodeficiency virus (HIV) have themselves become seropositive. Questionnaires were completed in January 1988 by 15 women who were in long-term, monogamous relationships with HIV-positive hemophiliacs; 11 of the women were not HIV seropositive and 4 were. None of the couples was abstaining from sexual intercourse, and during the 4 weeks prior to responding, the couples had intercourse a mean of 6.2 times. Sixty percent always used condoms, 13 percent did so most of the time, and the remaining 27 percent did sometimes. Condom use was not significantly related to either frequency of intercourse, the women's knowledge of acquired immunodeficiency syndrome (AIDS) and AIDS-risk reduction, the actual HIV status of both partners and the women's perceived status of both, the extent of the women's worry about contracting AIDS, their reported degree of negative impact from AIDS, or to their mood, age, or education. All women who reported not always using condoms had been informed of their own and their partner's HIV status; were counseled repeatedly regarding risk reduction; acknowledged the possibility of heterosexual HIV transmission; said they knew of recommendations for the use of condoms; recognized their risk of HIV infection; claimed some degree of worry about acquiring HIV through sexual activity; had children at home; and were not, with one exception, trying to become pregnant. There were several possible factors influencing the decision by women at high risk for acquiring HIV not to use condoms. Among them were complaints that the women found condoms unpleasant or an unwanted reminder of AIDS, a sense of obligation or a drive to continue unaltered sexual relations, the false reassurance of HIV-negative test results for some of the women who did not always use condoms, a willingness to sacrifice and to share their partner's fate, a desire to avoid communicating rejection and adding to their partner's burdens, and difficulty changing long-standing behavior patterns despite logical understanding of the risks involved.     

Comparison of human immunodeficiency virus related knowledge, attitudes, intentions, and behaviors among sexually active and abstinent young adolescents.

Although young sexually active adolescents are at greater risk for human immunodeficiency virus (HIV) acquisition than their abstinent peers, little is known about their respective HIV-related knowledge, attitudes, and general risk behaviors. This study of middle school adolescents (n = 1379; mean age, 13.2 years) found that the sexually active boys, compared with their peers, were less knowledgeable about HIV, less fearful of HIV, less tolerant of people with acquired immunodeficiency syndrome (AIDS), riskier in non-HIV-related attitudes and had a greater history of other risk behavior. A similar, but less marked pattern, was found for girls. It is suggested that physicians counsel all adolescents about HIV and sexuality during office visits and that early adolescent sexuality should prompt special efforts in HIV education/counseling.     

HIV/AIDS knowledge and attitudes among alcohol and drug abusers in Egypt

The aim of this study was to assess knowledge, attitudes and practice towards HIV/AIDS among alcohol and drug abusers and the effect of health education (HE) on their knowledge and attitudes. Participants were 265 substance abusers, recruited from 8 addiction rehabilitation centers. A base line study preceding HE was done using a questionnaire composed of five sections. Three scores were developed to assess HIV/AIDS related knowledge. The base line study indicates that addicts with good knowledge scores > or =75%) regarding modes of transmission were significantly higher among males than females. About 70% of the addicts had negative attitudes towards dealing with HIV/AIDS patients, while 55.5% felt sympathy for them. Eleven percent of the injection drug abusers were sharing needle with others, while 38% of the participating females were previously convicted of prostitution. Logistic analysis showed that high level of education was the best predictive variable for good knowledge scores (> or =75%). Evaluation of the health education program revealed a highly significant increase in the knowledge scores among both males and females compared to the pretest scores. An increase in the percentages of male and female addicts with improved attitudes towards HIV/AIDS patients was also noted after HE. So, HE was found to be a successful tool in improving the knowledge and attitudes of substance abusers towards HIV/AIDS.     

Sexual behavior, knowledge, and attitudes about AIDS among college freshmen.

We surveyed 158 college freshmen on an urban campus to determine their sexual practices and their knowledge and attitudes about acquired immunodeficiency syndrome (AIDS). Many students (47%) were heterosexually active; 1% were homosexual, 1% were bisexual, and 51% had not been sexually active. Among the 77 sexually active students, many engaged in activities that can facilitate transmission of human immunodeficiency virus (HIV): 58% did not always use condoms with a new partner; 31% had had two or more sex partners in the last year; 8% engaged in anonymous sex; and 14% of sexually active women had anal intercourse. Although most sexually active students said they would use condoms more or reduce the number of their sexual partners if they believed these changes would reduce "my risk for getting AIDS," few students had adopted these safer sexual practices. Safer sexual practices were associated with heightened personal concerns about AIDS but not with knowledge, which was at a high level. These findings underscore the need for preventive programs that overcome the gap between knowledge and safer sexual behaviors in this and similar groups of adolescents and suggest that programs that heighten personal concerns may be most effective. Community-based physicians who care for adolescents should develop such preventive programs and integrate them into their practices.     

北京市中学校医预防艾滋病健康教育的调查

目的：了解北京市中学校医预防艾滋病知识,态度及在学校开展预防艾滋病健康教育情况。方法：以不记名问卷方式对北京市4个城区中180名中学校医进行调查。结果：44．4％的校医接受过预防艾滋病健康教育培训。在被调查的中学校医中,分别有97．8％,97．2％,95．0％知道HIV可通过性交、母婴、血液途径传播;61．7％知道HIV不通过共用厕所传播;48．3％和53．3％知道尚无有效的预防艾滋病的疫苗,也无治愈艾滋病的方法,分别有98．2％,96．6％,67．5％的校医赞同在大学,中学和小学高年级开展预防艾滋病健康教育;有16．2％的校医回答愿意与HIV感染在同一办公室工作,在过去的1998－1999年里,有58．3％的校医给学生讲过艾滋病的传播途径,46．1％的校医给学生讲过如何避免感染艾滋病,分别有66．7％和50．0％的校医认为在学校开展预防艾滋病健康教育时遇到的或将要遇到的困难是缺少合适的教师参考书和难以把握教育的度。77．2％的校医希望接受预防艾滋病健康教育培训。结论：中学校医急需得到学校预防艾滋病健康培育培训。     

AIDS knowledge and attitudes for 1992. Data from the National Health Interview Survey

In 1992, levels of knowledge about the major modes of human immunodeficiency (HIV) transmission remained high in all sociodemographic groups examined. Knowledge about other aspects of acquired immunodeficiency syndrome (AIDS) was more variable with older and less educated adults generally being less knowledgeable. Changes in knowledge between 1991 and 1992 included: An increase from 86 to 95 percent in the proportion who had heard the AIDS virus referred to as "HIV" An increase from 15 to 22 percent in the proportion of young adults (18-29 years of age) who planned to be tested in the next year An increase from 13 to 17 percent in the proportion of adults who had a coworker, relative, or friend with AIDS An increase from 69 to 75 percent in the proportion of parents of 10-17-year-olds who had ever discussed AIDS with their children.     

江苏口岸出境人员艾滋病相关知识态度行为现状调查

目的:通过调查了解江苏口岸出境人员艾滋病相关知识、态度、行为的基本情况。方法:采用随机分层整群抽样方法,抽取江苏口岸出境人员为调查对象,进行现场问卷调查。结果:出境人员对艾滋病病毒感染者和病人态度认识不足,不同职业出境人员之间艾滋病相关知识知晓率有显著性差异。自述有商业性伴侣的出境人员中仅有51.7%能够每次或经常使用安全套。结论:江苏口岸出境人员对艾滋病防治知识、对感染者及病人态度和行为方面存在误区,应进一步加强宣传教育。     

Primary care physicians' assessment and prevention of HIV infection

The degree and depth to which primary care physicians counsel patients at risk for human immunodeficiency virus (HIV) infection is a major concern. To determine which factors influence whether physicians counsel patients at risk for HIV, primary care physicians's clinical experience, knowledge, attitudes, and preventive counseling advice in hypothetical case scenarios were assessed. Ninety-nine adult primary care physicians in the Washington, D.C., metropolitan area were interviewed by telephone from May through November 1987. Ninety-one physicians had tested or referred patients for HIV antibody tests. However, 58% could not name the ELISA or Western blot as the tests. The most frequent HIV prevention recommendations were using condoms (67.7%), abstaining from sexual activity (36.4%), getting tested for HIV (30.3%), and safe sex (23.2%). Naming the HIV antibody tests was the most significant predictor of preventive counseling advice; other significant predictors included physicians' personal comfort with counseling homosexual patients and various physician practice and demographic characteristics. Previous studies showed that homophobia was the main inhibitor of effective AIDS counseling. These results suggest that physicians' lack of knowledge and general discomfort in counseling patients about sexual risk factors, rather than homophobia alone, are important barriers to preventive counseling about HIV infection.     

北京市丰台区高校新生艾滋病认知与检测意愿调查

  目的  了解北京市丰台区大学新生艾滋病认知情况与检测意愿,为进一步开展大学生防艾教育提供参考依据。  方法  采用整群抽样方法,从北京市丰台区4所高等院校中的新生军训营中,各随机抽取2个连,被抽取到的连队中的全部学生共1 248名参与调查问卷,内容包括学生基本情况、艾滋病知晓情况、艾滋病检测意愿等。  结果  87.18%的学生知晓艾滋病相关知识,62.98%具有检测意愿。外地生源的学生艾滋病检测意愿(67.39%)高于北京生源学生(55.65%)(χ2=17.32,P < 0.05)。知晓艾滋病相关知识的学生检测意愿(65.26%)强于不知晓者(47.50%)(χ2=18.87,P < 0.05)。接受艾滋病检测的主要顾虑是担心泄露隐私(23.24%)和费用问题(18.59%)。多因素Logistic回归分析显示,艾滋病基本知识8道题目中,提高其中5道题目的知晓率有助于提升检测意愿(P值均 < 0.05)。多数学生更倾向在医院和疾病预防控制中心获取艾滋病检测服务,接受率分别为68.51%和42.79%。  结论  有针对性地对大学生艾滋病认知的薄弱环节开展相关健康教育活动,有助于提升艾滋病检测意愿。     

Support for hospital-based HIV testing and counseling: a national survey of hospital marketing executives.

Today, hospitals are involved extensively in social marketing and promotional activities. Recently, investigators from the Centers for Disease Control and Prevention (CDC) estimated that routine testing of hospital patients for human immunodeficiency virus (HIV) could identify more than 100,000 patients with previously unrecognized HIV infections. Several issues are assessed in this paper. These include hospital support for voluntary HIV testing and AIDS education and the impact that treating AIDS patients has on the hospital''s image. Also tested is the hypothesis that certain hospitals, such as for-profit institutions and those outside the AIDS epicenters, would be less supportive of hospital-based AIDS intervention strategies. To assess these issues, a national random sample of 193 executives in charge of hospital marketing and public relations were surveyed between December 1992 and January 1993. The survey was part of an ongoing annual survey of hospitals and included questions about AIDS, health education, marketing, patient satisfaction, and hospital planning. Altogether, 12.4 percent of executives indicated their hospital had a reputation for treating AIDS patients. Among hospitals without an AIDS reputation, 34.1 percent believed developing one would be harmful to the hospital''s image, in contrast to none in hospitals that had such a reputation (chi 2 = 11.676, df = 1, P = .0006). Although 16.6 percent did not know if large-scale HIV testing should be implemented, a near majority (47.7 percent) expressed some support. In addition, 15 percent reported that HIV-positive physicians on the hospital''s medical staff should not be allowed to practice medicine, but 32.1 percent indicated that they should.(ABSTRACT TRUNCATED AT 250 WORDS)     

什邡市大众艾滋病防治知识、态度现状调查

目的了解什邡市大众艾滋病知识及态度现状,为进一步做好大众的艾滋病健康教育提供指导依据。方法采用现况流行病学调查方法,应用多阶段抽样,对什邡市2个村,1个社区的480名大众进行面对面的问卷调查。结果人群艾滋病基本知识总体知晓率为82．8％;大众对艾滋病的3种传播途径知晓率较高,均在89．5％以上,但对非传播途径知晓率较低,仅有50．4％的人正确回答蚊虫叮咬不传播HIV;性生活使用安全套情况,不使用41．2％、偶尔使用23．6％;47名存在不固定的性伙伴关系人群中,68．1％不使用或偶尔使用安全套;获取艾滋病知识的主要途径是电视。结论什邡市大众的艾滋病健康教育应进一步加强,提炼艾滋病健康教育核心信息,针对目前目标人群不足的认知。     

中国5省市中学生危险行为现状（一）——艾滋病及性行为的知识态度行为

目的 了解中国学生危险行为,包括艾滋病及性行为的知识态度行为现状,方法 1999年5月到6月,选取中国北京,天津、深圳、沈阳和云南40所中学的初一和高一学生16580名,采取KAP（知、信、行）问卷调查,结果 中学生看过描写性行为作品的比例为34.8%,反对婚前性行为的比例为61.2%。发生性病的比例达3.0%,对艾滋病知识的掌握,知道3条传播途径的比例为73.0%,知道日常生活接触不传播艾滋病的比例占44.6%,与家人或朋友谈论艾滋病知识的比例分别为44.9%和65.25%。但是愿意和AIDS/HIV感染（性传播疾病/艾滋病病毒感染）同班学习的比例仅为29.0%。结论 在中学生中尽快开展正确系统的性知识和预防HIV/AIDS知识的健康教育,并加强对中学生性态度、性行为的引导是必要的。     

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.     

Physician and infection control practitioner HIV/AIDS reporting characteristics.

We surveyed a random sample of South Carolina physicians and infection control practitioners about the reporting of human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) cases. Of physicians surveyed, 79% indicated that HIV infection as well as AIDS should be reported by name. The following characteristics were associated with those physicians who do not report AIDS cases: not feeling responsible for reporting, not reporting a case perceived to have been reported in another state, believing that information required for reporting is not on the chart, and residing in an urban setting. Targeted education can address these underreporting factors.     

上海市青少年危险行为现状研究(一)--艾滋病及性行为的知识态度行为

目的：了解上海市中学生艾滋病及性行为的知识态度行为现状。方法：2002年4月至6月选取105所普通中学和中等职业学校的初一、高一9246名学生，采取KAP(知、信、行)问卷调查。结果：中学生在学校里没有接受过预防艾滋病的健康教育的比例为49．3％。艾滋病知识的掌握，3条传播途径不完全知道的比例为27．8％，不知道日常生活接触不传播艾涝病的比例为24．7％，没有与亲友谈论过艾滋病的比例为66．7％，而且86．0％学生都表示不愿意和AIDS／HIV感染者同班学习。中学生看过描写性行为的书刊、音像制品等的比例为23．8％，赞成婚前性行为的比例为18．5％，高中阶段学生曾发生性行为的比例2．3％。结论：用多种形式，包括同伴教育在内健康教育方法，在中学生中尽快开展艾送病预防和生殖健康教育。