Understanding fear of contagion among physicians who care for HIV patients.
BACKGROUND
Fear of contagion has been identified as a potential deterrent for primary care physicians who would otherwise care for HIV patients. This study examines physicians' fears of occupational HIV transmission and the ways that they cope with those fears.


METHODS
Thirty community-based primary care physicians who were caring for HIV patients were interviewed about their experiences with HIV patients and the meanings they ascribe to those experiences. Qualitative content and narrative analysis were used.


RESULTS
Fear of contagion was common despite the relatively low reported self-assessment of risk by primary care physicians. Most physicians considered their level of risk acceptable, but for some it seemed to take a high emotional toll. Some physicians identified their fear as "irrational." Physicians reported tension between fear of contagion and ethical responsibility to care for HIV patients. Some physicians were overattentive to infection control measures, whereas others used universal precautions inconsistently. Physicians continued to care for HIV patients despite their fears. Some physicians' family members needed information and reassurance about transmission of HIV.


CONCLUSIONS
Some physicians who care for HIV patients are poorly equipped to deal with their own fears. There is a need to examine in greater depth the relationship between fear of contagion and willingness to provide care, and to examine other factors that may be contributing to the expression of these fears.
Epstein
R M
RM
Highland Hospital, Program for Biopsychosocial Study, Rochester, N.Y.
Christie
M
M
Frankel
R
R
Rousseau
S
S
Shields
C
C
Suchman
A L
AL
D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D005194:Family Practice; D005239:Fear; D005260:Female; D015658:HIV Infections / Q000517:prevention & control / Q000523:psychology* / Q000635:transmission*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009511:New England; D016273:Occupational Exposure / Q000517:prevention & control; D010820:Physicians / Q000523:psychology*; D016635:Universal Precautions