Many Medical Residents Do Not Want to Care for AIDS Patients, UC San Francisco Study Finds

Medical Residents & AIDS Patients - Page 2

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Internal medicine residents from 41 U.S. training programs were surveyed to determine
their intentions to provide AIDS care after completing their training and to examine
reasons why attitudes might vary. The training programs represented all areas of the
country and were small to large in number of residents. Some were programs that saw many
AIDS patients and some few. There were 1045 responses to the survey from residents who
were divided among each of the three years of training, said Cooke.
The survey included questions about attitudes toward gays, IV drug users, and ethnic
patients, assessment of risk of contracting HIV infection by accidental exposure,
attitudes about professional duty and responsibility, career plans for future medical
practice, a personal assessment of emotional status, and the resident's experience with
HIV patients.
Summary scores based on a scale of responses resulted in 17 percent of the residents
who were strongly in favor of caring for AIDS patients, 20 percent who were somewhat in
favor, and 63 percent who were not planning to care for persons with HIV infection.
"It is certainly fair to say that, of the residents being trained in internal
medicine today, those with a positive interest in treating AIDS patients are clearly in
the minority," said Cooke.
Although 66 percent -of those responding to the survey indicated concern about risks
of contracting HIV infection through occupational exposure, Cooke said, the difference
between those who would choose to care for AIDS patients and those who wouldn't was
influenced more by the individual's prejudices about gays and IV drug users and sense of
professional duty and ethical responsibility.
"If these are the real issues, for training in internal medicine we should be
developing programs to help people recognize and deal with their feelings and prejudices
about the people who get AIDS," Cooke said. "We should be helping them develop attitudes
that promote care."
Whether prejudices can be influenced and whether training programs can address those
issues are questions the medical profession will have to examine, Cooke said. "We must
look at what is feasible to implement in our training programs on a large scale."
Co-authors are Barbara Koenig, PhD, RN, UCSF assistant adjunct professor of medical
anthropology; Natasha Beery, MA, UCSF staff research associate; and Susan Folkman, PhD,
UCSF research psychologist.
The research was supported in part by grants from the UC Universitywide Task Force on
AIDS and the National Institute of Mental Health.