Inequality and unwillingness to care for people living with HIV/AIDS: a survey of medical professionals in Southeast China

This study was aimed at assessing physicians' and physician assistants' knowledge and attitudes toward HIV/AIDS and identifying determinants of willingness to care for infected individuals in Southeast China. From May to June 2004, 454 physicians and physician assistants from 5 different medical facility levels in Fujian Province, China, undertook a survey on knowledge, attitude, behavior, and practice (KABP). Only 40.4% (95% confidence intervals: 35.9, 44.9) were willing to provide healthcare services for people living with HIV/AIDS (PLWHAs). Knowledge (p < 0.001) and attitude scores (p = 0.01) as well as the proportion of those willing to provide care (p < 0.001) significantly differed by facility level. Multivariate analysis identified supportive attitudes toward PLWHAs (p < 0.001), self-confidence in providing care (p < 0.001), and facility level as significant predictors of willingness to care for infected individuals. Village medical stations showed the most unfavorable outcomes. Enhanced education as well as specific programs promoting supportive attitudes and willingness to care is therefore required, especially among those working at lower facility levels in remote areas.