Tehran dentists’ self-reported knowledge and attitudes towards HIV/AIDS and observed willingness to treat simulated HIV-positive patients

Abstract

Dentists' self-reported attitudes towards patients with HIV/AIDS might not reflect their actual behaviour. In this study 2 observers posed as HIV-positive patients and directly evaluated the behaviour of 300 dentists in Tehran, Islamic Republic of Iran. Two months later another observer interviewed the same dentists at their offices regarding AIDS-related knowledge and self-reported attitudes. Only 14.9% of dentists agreed to treat the simulated HIV-positive patients, 78.5% referred and 6.6% rejected them. Older age, longer work experience, graduation from a non-Iranian university and not having additional degrees were significantly related to adverse behaviours. Mean scores were 8.3 (SD 9.7) (out of 18) for knowledge and 17.5 (SD 7.1) (out of 39) for attitude. There were no significant correlations between dentists' knowledge and attitude or between knowledge and behaviour, but there was a weak positive correlation between self-reported attitude and observed behaviour ‬ ‫امللحوظ‬ ‫السلوك‬ ‫وبني‬ ‫املواقف‬ ‫عن‬ ‫الذايت‬ ‫اإلبالغ‬ ‫بني‬ ‫شوهد‬ ‫الذي‬ ‫الضعيف‬ ‫اإلجيايب‬ ‫الرتابط‬ ‫باستثناء‬ ‫وسلوكهم،‬ ‫معارفهم‬Connaissances et attitudes autodéclarées des dentistes à Téhéran par rapport au VIH/sida et disposition observée à soigner les patients se présentant comme positifs pour le VIH RÉSUMÉ Il est possible que l'attitude autodéclarée des dentistes vis-à-vis des patients atteints du VIH/sida ne corresponde pas à leur comportement en situation réelle. Dans le cadre de cette étude, deux observateurs se sont fait passer pour des patients séropositifs pour le VIH et ont directement évalué le comportement de 300 dentistes de Téhéran (République islamique d'Iran). Deux mois plus tard, un autre observateur a interrogé les mêmes dentistes dans leur cabinet au sujet de leurs connaissances et de leur attitude autodéclarées à propos du sida. Seuls 14,9 % des dentistes ont consenti à traiter les patients ayant déclaré une séropositivité fictive, 78,5 % les ont orientés vers d'autres confrères et 6,6 % ont refusé de les soigner. Un âge plus avancé, une expérience professionnelle plus longue, des études suivies dans une université non iranienne et le fait de ne pas avoir de diplômes supplémentaires étaient des facteurs significativement associés à des comportements de refus. Les scores moyens étaient de 8,3 (E.T. 9,7) (sur 18) pour les connaissances et de 17,5 (E.T. 7,1) (sur 39) pour l'attitude. Aucune corrélation significative n'a été observée entre les connaissances et les attitudes des dentistes ni entre les connaissances et le comportement, mais une faible corrélation positive a été retrouvée entre l'attitude autodéclarée et le comportement observé.‫املتوسط‬ ‫لرشق‬ ‫الصحية‬ ‫املجلة‬ ‫عرش‬ ‫الثامن‬ ‫املجلد‬ ‫التاسع‬ ‫العدد‬ 929

Tehran dentists' knowledge and attitudes towards hepatitis B and their willingness to treat simulated hepatitis B positive patients

“…However, even in North America, where there are strict ethical requirements to treat, many dentists still remain unwilling to treat patients suffering from bloodborne infectious diseases (16). Besides being unethical/illegal, clinicians' reluctance to treat such patients can have serious public health consequences (14). Many hepatitis B patients conceal their condition (12), and dentists' negative attitudes might reinforce patients' desire to conceal, resulting in a greater risk of spread of the disease (4,10,14).…”

“…Dental staff are 2.5 to 10 times more likely than the general population to become infected with hepatitis B virus (HBV), and they have the highest risk among all fields of health-care providers because they are in contact with contaminant fluids, droplets, aerosols and small sharp instruments (1)(2)(3)(4)(5)(6)(7)(8)13). Many dentists could therefore be reluctant or unwilling to treat HBV-positive patients due to the high exposure risks (4,14) and extra difficulties in dealing with them. Furthermore, identifying those capable of transmitting HBV is difficult, since many infected patients may be unaware of their carrier status, may be asymptomatic or simply may not want to disclose their infectious condition (12).…”

“…Besides being unethical/illegal, clinicians' reluctance to treat such patients can have serious public health consequences (14). Many hepatitis B patients conceal their condition (12), and dentists' negative attitudes might reinforce patients' desire to conceal, resulting in a greater risk of spread of the disease (4,10,14).…”

“…Attitudes themselves might be a reflection of improved knowledge and confidence (14,(17)(18)(19). Proper knowledge of health staff about viral hepatitis transmission and prevention, and improved attitudes and willingness to treating infected patients, can assist considerably in eliminating the spread of HBV (14,17,20). This is especially important in developing countries where there are high rates of hepatitis infection in the population (11,21).…”

“…The key to encouraging clinicians to treat patients with contagious diseases is not legal penalties (16) but improving their attitudes (14,17). Attitudes themselves might be a reflection of improved knowledge and confidence (14,(17)(18)(19).…”