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Factors associated with refusal to treat
HIV-infected patients: the results of a
national survey of dentists in
Canada
American Journal of Public Health, Vol 89, Issue 4
541-545, Copyright © 1999 by American
Public
Health Association
GM McCarthy, JJ Koval and JK MacDonald
School of Dentistry, University of Western Ontario,
London. gmccarth@julian.uwo.ca
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.
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