Worm A M, Smith E, Sørensen H, Haxholdt H
Department of Dermato-Venereology, Bispebjerg Hospital, Copenhagen, Denmark.
Genitourin Med. 1996 Aug;72(4):283-5. doi: 10.1136/sti.72.4.283.
To examine attitudes, experience and preliminary results of partner notification (PN) for HIV infection in Denmark among the doctors who inform one of their patients about being HIV infected.
The doctors who had reported to the national HIV surveillance unit about a new-identified HIV infected person, during a 9 months period, were searched for one year later. The traced doctors were interviewed. The results of the interview related to 102 out of 195 (52%) reports were compared between the 48 interviewed general practitioners (GPs) and the 33 interviewed hospital doctors (HDs). The proportion of traced reporting doctors were higher among GPs than among HDs.
Both GPs and HDs found it difficult to give a positive HIV test result and wanted trained counsellors to work with them in the PN process. Less experience and fewer post-graduate courses about HIV may explain the GPs' lack of confidence to follow-up asymptomatic HIV positive patients. It was neither a routine for all the GPs or for all HDs to ask about patient behaviour nor to discuss safe sex with their index patients, and screening for other sexually transmitted diseases were seldomly performed. The numbers of partners notified, especially by the doctors were low.
HIV reporting doctors in Denmark are motivated for PN. Educational programmes about counselling and care of HIV infected patients should, however, be offered at intervals, especially to GPs. The outcome of PN can only be measured to a certain level as long as exposed partners are neither obliged to be tested nor to be counselled and as long as information about counselling and testing can not be shared between doctors in different settings.
调查丹麦医生在告知患者其感染艾滋病毒时,对艾滋病毒感染伴侣通知(PN)的态度、经验和初步结果。
在9个月期间向国家艾滋病毒监测部门报告新确诊艾滋病毒感染者的医生,一年后被追踪调查。对追踪到的医生进行访谈。比较了48名接受访谈的全科医生(GPs)和33名接受访谈的医院医生(HDs)中,与195份报告中的102份(52%)相关的访谈结果。追踪到的报告医生比例在全科医生中高于医院医生。
全科医生和医院医生都发现很难给出艾滋病毒检测呈阳性的结果,并希望有经过培训的咨询人员在伴侣通知过程中与他们合作。关于艾滋病毒的经验较少和研究生课程较少,可能解释了全科医生对随访无症状艾滋病毒阳性患者缺乏信心的原因。询问患者行为或与索引患者讨论安全性行为,既不是所有全科医生的常规做法,也不是所有医院医生的常规做法,很少进行其他性传播疾病的筛查。通知的伴侣数量,尤其是医生通知的数量很低。
丹麦的艾滋病毒报告医生有进行伴侣通知的积极性。然而,应定期提供关于艾滋病毒感染患者咨询和护理的教育项目,尤其是针对全科医生。只要暴露的伴侣既没有义务接受检测也没有义务接受咨询,并且只要不同机构的医生之间不能共享咨询和检测信息,伴侣通知的结果就只能在一定程度上进行衡量。