Factors associated with refusal to treat HIV-infected patients: the results of a national survey of dentists in Canada.

Abstract

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.

An investigation of dentists' knowledge, attitudes and practices towards HIV+ and patients with other blood-borne viruses in south cheshire, UK

“…1,9 This was borne out in the current study where significant differences were found between those obtaining higher compared with lower oral knowledge scores and willingness to treat various 'at risk' patient groups. For instance, those with higher scores were significantly more likely than lower scorers to respond that they would 'have no hesitation' in treating the following patients groups: a homosexual/bisexual man (96% compared with 78%, χ 2 = 11, df = 2, P < 0.001); a hemophiliac (77% compared with 58%, χ 2 = 6, df = 2, P < 0.05); and a HIV/AIDS patient (55% compared with 35%, χ 2 = 6, df = 2, P < 0.05).…”

“…Previous studies have shown that a sense of ethical responsibility is important because it is one of the strongest predictors of refusal or unwillingness to treat HIV/ AIDS patients. 9 For instance, in the McCarthy et al (1999) study, it was found that respondents who did not have a sense of ethical responsibility were nine times more likely to report that they would refuse to treat HIV infected patients than respondents who believed they did have such an ethical responsibility. In this respect, it is interesting to note the significant correlations which exist in the current investigation between the statement 'As a dentist, I have an ethical responsibility to provide dental care to a HIV positive person' and the variables addressing attitudes towards various 'at risk' patients (see Table 6).…”

“…Despite these recommendations, however, it has been suggested that many dentists remain reluctant to treat patients with HIV/AIDS and other groups at high risk for bloodborne pathogens. 2 Previous studies in both the UK 3 and US 4,5 have examined dentists' knowledge, attitudes and behaviours in order to assess which factors may be influential in affecting dentists' willingness to treat HIV/AIDS patients. It has been suggested, for instance, that dentists' attitudes and behaviours towards HIV/AIDS patients may be a reflection of their knowledge of HIV/AIDS.…”

“…It has been suggested, for instance, that dentists' attitudes and behaviours towards HIV/AIDS patients may be a reflection of their knowledge of HIV/AIDS. 1,2 This paper derives from research conducted in the North West of England and funded by South Cheshire Health Authority. The Health Authority felt there was a need for this research because anecdotal evidence within an influential charity HIV/ AIDS organisation in the region suggested that some HIV positive individuals had been experiencing difficulties accessing NHS dental care.…”

Actitud de los estudiantes en tres facultades de odontología en Santiago de Cali, Colombia, frente a pacientes con VIH

“…Algunos estudios han mostrado que el rechazo para atender pacientes con diagnóstico de VIH se explica por la falta de compromiso ético y profesional (12,16). Los resultados de esta investigación sugieren que existe mayor oportunidad de atender pacientes VIH+ cuando los estudiantes se sienten ética o profesionalmente comprometidos.…”