title: A survey of exposures, practices and recommendations of surgeons in the care of patients with human immunodeficiency virus.
abstract: Policy makers face a conflict between satisfying concerns of health care workers (HCW) about the occupational risk of human immunodeficiency virus (HIV) infection and ensuring adequate care for patients. This conflict is particularly severe in the field of surgery. We mailed a questionnaire on the surgical care of patients infected with HIV to 1,461 surgeons in New York City and Philadelphia, and 551 (37.7 per cent) responded. Although 1.9 per cent currently were testing all patients for HIV, 42.6 per cent of surgeons believed that all patients in their hospital should be tested. Of the surgeons who responded, 6.3 per cent refused to treat any patient infected with HIV. Less than 50 per cent recommended the use of barrier precautions on all patients in their hospital. Surgeons in New York City were significantly more likely than those in Philadelphia to favor separate facilities for HIV-infected patients. Surgeons considering themselves at higher occupational risk were more likely than those at lower risk to favor widespread testing, separate facilities and use of precautions. Surgeons reported a wide range of opinions. Their approach to the use of barrier precautions differs from the Centers for Disease Control recommendations. The patterns observed suggest that distinct policies may be appropriate for different hospitals.
authors.affiliation: Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia.
authors.forename: D A
authors.initials: DA
authors.lastname: Mandelbrot
authors.forename: W R
authors.initials: WR
authors.lastname: Smythe
authors.forename: S A
authors.initials: SA
authors.lastname: Norman
authors.forename: S C
authors.initials: SC
authors.lastname: Martin
authors.forename: R M
authors.initials: RM
authors.lastname: Arnold
authors.forename: G H
authors.initials: GH
authors.lastname: Talbot
authors.forename: P D
authors.initials: PD
authors.lastname: Stolley
mesh_terms: D005260:Female; D013502:General Surgery; D015658:HIV Infections / Q000175:diagnosis / Q000517:prevention & control / Q000628:therapy*; D007722:Health Knowledge, Attitudes, Practice; D006291:Health Policy; D006801:Humans; D008297:Male; D037141:Mandatory Programs; D008875:Middle Aged; D009784:Occupational Diseases / Q000517:prevention & control*; D010356:Patient Isolation; D011050:Policy Making; D011795:Surveys and Questionnaires; D014481:United States