Primary care physicians' assessment and prevention of HIV infection.
Primary care physicians' assessment and prevention of HIV infection.
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初级保健医生对艾滋病毒感染的评估和预防。
DOI：
10.1016/s0749-3797(18)31079-1
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发表时间：
1989
影响因子：
5.5
通讯作者：
Daylanne K. English
中科院分区：
文献类型：
--
作者：
L. Fredman;D. Rabin;M. Bowman;C. Bandemer;K. Sardeson;V. Taggart;Daylanne K. English
初级保健医生为有感染人类免疫缺陷病毒（HIV）风险的患者提供咨询的程度和深度是一个主要问题。为了确定哪些因素影响医生是否为有HIV风险的患者提供咨询，对初级保健医生的临床经验、知识、态度和假设病例情景中的预防咨询建议进行了评估。华盛顿，华盛顿特区的99名成人初级保健医生，从1987年5月到11月，通过电话采访了大都市地区。91名医生对病人进行了艾滋病毒抗体检测或转诊。但58%的人不能说出ELISA或Western blot作为检测方法。最常见的艾滋病毒预防建议是使用避孕套（67.7%），避免性活动（36.4%），进行艾滋病毒检测（30.3%）和安全性行为（23.2%）。艾滋病病毒抗体检测是预防咨询建议的最重要的预测因素;其他重要的预测因素包括医生对咨询同性恋患者的个人舒适度以及各种医生实践和人口统计学特征。先前的研究表明，同性恋恐惧症是有效的艾滋病咨询的主要抑制因素。这些结果表明，医生缺乏知识和一般的不适，在咨询病人的性风险因素，而不是同性恋恐惧症单独，是重要的障碍，预防咨询艾滋病毒感染。
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’ 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.