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Improving the care of aids patients: roles of provider gender and specificity of training.
Joseph MM; Laux L; Wente S; Thornby J; Baylor College of Medicine,
September 30, 1990
Int Conf AIDS. 1989 Jun 4-9;5:697 (abstract no. M.D.O.45). Unique

OBJECTIVE: To identify mechanisms at work in Health Care Professionals' (HCPs) desire to avoid AIDS patients. METHODS: In four sequential studies we have surveyed 343 senior medical students, 140 college undergraduates, and 87 HCPs to assess their AIDS knowledge, attitudes, beliefs and practices. Primarily we used a Likert-type scale with responses factor analyzed to derive scales as linear functions using unit weights of items with factor loadings greater than 0.40 in absolute value. For analyses, derived scales (alpha greater than 0.89) were used either as dependent variables or covariates. RESULTS: Fear of infection is the principal cause of these respondents' desire to avoid an AIDS patient. But, important gender differences were also found that have relevant implications for improving AIDS patient care. Males express more homophobia (p greater than 0.0002), more fear of infection (p greater than 0.0003), and more antipathy toward AIDS patients (p greater than 0.01) than do females. Antipathy toward AIDS patients was associated with other maladaptive attitudes (homophobia [+0.56], thanatophobia [+0.45], authoritarianism [+0.39], positive self-image [-0.38] and psychological-mindedness [-0.44]). Medical students planning careers in internal medicine scored 30% higher on the homophobic scale than future psychiatrists (p less than 0.02). We next investigated if the socialization that occurs among specific HCP occupations can reduce HCPs' sex dysphoria. By comparing attitudes of female MDs, nurses and midwives, ANOVA revealed that midwives were more at ease discussing birth control practices than either female MDs (p greater than 0.01) or nurses (p greater than 0.01). CONCLUSION: More attention, both to gender differences in how HCPs perceive AIDS patients and to the desensitization that can be induced during health professions training, should produce better care for AIDS patients.

Acquired Immunodeficiency Syndrome/*THERAPY *Attitude of Health Personnel *Health Manpower Health Occupations/EDUCATION Homosexuality Human Phobic Disorders Physician's Role *Sex Factors ABSTRACT

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