Preventing tuberculosis among HIV-infected persons: a survey of physicians' knowledge and practices.
BACKGROUND
Guidelines exist for screening, diagnosing, and preventing tuberculosis (TB) among HIV-infected persons, but their application and utility are unknown.


METHODS
We conducted a survey of knowledge and practices among 1,300 physicians in the San Francisco Bay area to assess their practices towards TB among HIV-infected persons.


RESULTS
Of 630 respondents, 350 (56%) provided care for HIV-infected persons. Thirty-four percent of the respondents had seen the most recent guidelines for preventing tuberculosis among HIV-infected persons; 65% routinely provide information to HIV-infected patients about the risks of exposure to Mycobacterium tuberculosis; 39% provide annual tuberculin skin testing (TST) to HIV-infected patients without a history of a positive test; 86% knew that >/=5-mm induration is considered a positive TST result in HIV-infected persons; and 47% provide a 12-month regimen of chemoprophylaxis for HIV-infected persons who have a positive TST but not active tuberculosis. Physician specialty and experience with HIV-infected persons were not strongly correlated; experience was a better predictor of correct knowledge and practices.


CONCLUSIONS
Many physicians were not aware of the standards of care for preventing tuberculosis among HIV-infected patients, even in a geographic area with a high prevalence of M. tuberculosis and HIV.
DeRiemer
K
K
Division of Public Health Biology and Epidemiology, School of Public Health, University of California, Berkeley, California, 94720, USA.
Daley
C L
CL
Reingold
A L
AL
D017088:AIDS-Related Opportunistic Infections / Q000517:prevention & control* / Q000523:psychology; D019072:Antibiotic Prophylaxis / Q000706:statistics & numerical data; D000995:Antitubercular Agents / Q000627:therapeutic use; D002140:California; D016009:Chi-Square Distribution; D002983:Clinical Competence; D015988:Cohort Effect; D019538:Health Care Surveys; D006801:Humans; D007538:Isoniazid / Q000627:therapeutic use; D008511:Medicine / Q000706:statistics & numerical data; D010349:Patient Compliance; D010353:Patient Education as Topic / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data* / Q000639:trends; D011364:Professional Practice / Q000706:statistics & numerical data; D013038:Specialization; D014374:Tuberculin Test / Q000523:psychology / Q000706:statistics & numerical data; D014376:Tuberculosis / Q000517:prevention & control* / Q000523:psychology
D000995:Antitubercular Agents; D007538:Isoniazid