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Factors associated with refusal to treat HIV-infected patients: the results of a national survey of dentists in Canada.

G M McCarthy, J J Koval and J K MacDonald

School of Dentistry, University of Western Ontario, London. gmccarth@julian.uwo.ca

OBJECTIVES: This study investigated dentists refusal to treat patients who have HIV. METHODS: A survey was mailed to a random sample of all licensed dentists in Canada, with 3 follow-up attempts (n = 6444). Data were weighted to allow for probability of selection and nonresponse and analyzed with Pearson's chi 2 and multiple logistic regression. RESULTS: The response rate was 66%. Of the respondents, 32% had knowingly treated HIV-infected patients in the last year; 16% would refuse to treat HIV-infected patients. Respondents reported willingness to treat HIV-infected patients (81%), injection drug users (86%), hepatitis B virus-infected patients (87%), homosexual and bisexual persons (94%), individuals with sexually transmitted disease(s) (94%), and recipients of blood and blood products (97%). The best predictors of refusal to treat patients with HIV were lack of ethical responsibility (odds ratio = 9.0) and items related to fear of cross-infection or lack of knowledge of HIV. CONCLUSIONS: One in 6 dentists reported refusal to treat HIV-infected patients, which was associated primarily with respondents' lack of belief in an ethical responsibility to treat patients with HIV and fears related to cross-infection. These results have implications for undergraduate, postgraduate, and continuing education.

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