Factors Related to the Attitude of General Dental Practitioners toward Treatment of HIV Carriers

DOI Web Site 20 References
  • INADA Kohei
    Division of Oral Health Services Research, Nagasaki University Graduate School
  • SHINSHO Fumiaki
    Nankoh Community Dental Health Centre:Japan HIV Centre
  • WATANABE Mitsuharu
    Matsuura Clinic Dental Department
  • KOMAI Tadashi
    Takarazuka City Health Insurance Clinic
  • FUKUDA Hideki
    Division of Oral Health Services Research, Nagasaki University Graduate School
  • GOTOH Mary
    Division of Oral Health Services Research, Nagasaki University Graduate School:Japan HIV Centre

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Other Title
  • 歯科診療所におけるHIV陽性者の診療受入れ姿勢と関連する要因
  • シカ シンリョウジョ ニ オケル HIV ヨウセイシャ ノ シンリョウ ウケイレ シセイ ト カンレン スル ヨウイン

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Abstract

Objective : A survey was undertaken to ascertain the factors related to the attitudes of general dental practitioners regarding the treatment of HIV carriers. Methods : Questionnaires on infection control and awareness/experience in the treatment of HIV + or hepatitis virus carriers were delivered in March, 2004 to 471 general dental practitioners selected from lists of graduates of two dental schools and of two dental study groups in Japan. Completed sheets were returned by post anonymously. Results : Completed sheets were collected from 431 respondents (91.5%). The percentage of those who reported to have treated a HIV+ patient was 2.5%. Whereas nearly 90% showed a willingness to treat HA+, HB+, and HC+ patients, only 31.9% showed a willingness to accept HIV+ patients. Of the respondents, 28.6% stated they would refuse to treat HIV positive patients, with 33.6% for AIDS patients. The main reasons they stated concerning the difficulty of dental treatment for HIV+ patients were as follows : (1) difficulty in disinfection, (2) dental staff's acceptance, (3) negative effects on other patients, and (4) the possibility of cross infection to health workers. Multiple logistic regression analysis showed four factors to be significantly correlated with the attitude concerning the treatment of HIV+ patients. The odds ratios of the factors were : 1.73 for 'practice or understanding of standard precautions', 0.57 for 'experience of needle injury', 3.50 for 'having been asked to treat an HIV+ patient', and 1.78 for 'advanced postgraduate experience of oral surgery or oral anesthesiology'. Discussion : These results suggest many dental practitioners still have a great misunderstanding concerning infection control : while most of them would accept a hepatitis virus carrier, which might represent a stronger possibility of infection, many of them would refuse an HIV carrier, which represents a lower possibility of infection. The reasons they cited were not based on scientific knowledge, but seemed to be affected by the possible negative effect on their other patients. The results also suggested that the more a dentist was aware of infection control, the more positively he/she may would accept an HIV carrier. Effective post graduate education on infection control based on current knowledge (CDC 2003, for example) to dental practitioners for practicing universal and/or standard precautions, and a change in the attitude of dental practitioners seems to be crucial for promoting the oral health care of people living with AIDS/HIV, with the proper consideration of their human rights as well as providing safer dentistry within the community.

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