Support for hospital-based HIV testing and counseling: a national survey of hospital marketing executives.

Today, hospitals are involved extensively in social marketing and promotional activities. Recently, investigators from the Centers for Disease Control and Prevention (CDC) estimated that routine testing of hospital patients for human immunodeficiency virus (HIV) could identify more than 100,000 patients with previously unrecognized HIV infections. Several issues are assessed in this paper. These include hospital support for voluntary HIV testing and AIDS education and the impact that treating AIDS patients has on the hospital's image. Also tested is the hypothesis that certain hospitals, such as for-profit institutions and those outside the AIDS epicenters, would be less supportive of hospital-based AIDS intervention strategies. To assess these issues, a national random sample of 193 executives in charge of hospital marketing and public relations were surveyed between December 1992 and January 1993. The survey was part of an ongoing annual survey of hospitals and included questions about AIDS, health education, marketing, patient satisfaction, and hospital planning. Altogether, 12.4 percent of executives indicated their hospital had a reputation for treating AIDS patients. Among hospitals without an AIDS reputation, 34.1 percent believed developing one would be harmful to the hospital's image, in contrast to none in hospitals that had such a reputation (chi 2 = 11.676, df = 1, P = .0006). Although 16.6 percent did not know if large-scale HIV testing should be implemented, a near majority (47.7 percent) expressed some support. In addition, 15 percent reported that HIV-positive physicians on the hospital's medical staff should not be allowed to practice medicine, but 32.1 percent indicated that they should. Also, 33.1 percent thought the hospital should be more involved in AIDS education. Finally, certain hospital characteristics,such as location and for-profit status, were not associated with support for hospital-based AIDS interventions. Contrary to what was hypothesized,however, hospitals in AIDS epicenters were less supportive of the CDC recommendations for some reason (X2 = 7.735, df = 1, P = .005).Support for AIDS education and voluntary testing is significant among hospital marketing and public relations executives. Over the past decade, community marketing and public relations have become an integral part of the hospital's business activities.However, financial pressures now are forcing hospitals to restrict these efforts. Findings reported in this paper suggest that future health care reform may assist public health aims by redirecting these endeavors towards the fight against AIDS and other preventable diseases, not eliminating them. Additional research is needed to determine why executives in AIDS epicenters are less supportive of large-scale hospital HIV testing and counseling in comparison with those outside these areas.