Infection control and HIV-related discrimination and anxiety. Glove use during venipuncture.
OBJECTIVE
Reports into HIV-related discrimination reveal continuing concerns about the behaviour of health care workers, particularly with reference to practices such as excessive or selective infection control. This study examines whether the selective adoption of an infection control procedure (using gloves during venipuncture) is related to discriminatory attitudes, anxiety about HIV/AIDS and the degree of contact with HIV-infected patients.


METHODS
In 1993 and 1994, 451 general practitioners (GPs) were surveyed in six of the 12 New South Wales Health Areas and Regions. The sample included 49 anti-retroviral prescribers. GPs were presented with six patient scenarios and asked with whom they would use gloves during venipuncture.


RESULTS
41.9% of GPs reported that they would selectively use gloves, and generally targeted the homosexual patient only, or combinations of patients that included the homosexual man. GPs revealed poor compliance with universal precautions, as only 37.5% reported that they would use gloves with all of the six patients. Intended glove use was significantly related to HIV-related discrimination (p < 0.0001) and anxiety about HIV/AIDS (p < 0.0001). GPs who selectively chose to use gloves had the highest discrimination and anxiety scores; GPs who chose not to use gloves with any of the patients had the lowest discrimination and anxiety scores, and were more likely to work in HIV medicine. Except for differences in Health Area, this study did not identify any factors that helped to explain which GPs consistently followed universal precautions.


CONCLUSIONS
This study demonstrates that selective infection control is related to discriminatory attitudes and anxiety about HIV/AIDS. GPs can avoid a discriminatory practice by consistently following universal precautions. More research is needed to identify the factors that promote good infection control practices.
School of Behavioural Sciences, Macquarie University, Sydney, NSW.
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Bermingham
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Kippax
D000163:Acquired Immunodeficiency Syndrome / Q000517:prevention & control / Q000635:transmission; D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D001007:Anxiety; D001291:Attitude of Health Personnel; D001315:Australia; D002648:Child; D003625:Data Collection; D005194:Family Practice / Q000592:standards / Q000706:statistics & numerical data*; D005260:Female; D017575:Gloves, Protective / Q000592:standards / Q000706:statistics & numerical data*; D015658:HIV Infections / Q000517:prevention & control / Q000635:transmission*; D006716:Homosexuality; D006801:Humans; D017053:Infection Control / Q000331:legislation & jurisprudence / Q000379:methods*; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D016602:Needlestick Injuries / Q000517:prevention & control*; D018962:Phlebotomy / Q000379:methods / Q000592:standards; D011247:Pregnancy; D011287:Prejudice; D011795:Surveys and Questionnaires; D016635:Universal Precautions / Q000706:statistics & numerical data