HIV-related avoidance and universal precaution in medical settings: opportunities to intervene.

OBJECTIVE: To determine the association between adherence to universal precaution (UP) and avoidance attitudes toward patients living with HIV/AIDS (PLH) among service providers. DATA SOURCES/
SETTING: A total of 1,760 health service providers were randomly selected from 40 county hospitals in two provinces of China. STUDY
DESIGN: A self-administered questionnaire was used to collect demographic characteristics, UP knowledge and training, UP adherence, availability of UP supplies at work, and avoidance attitudes toward PLH in a cross-sectional survey. DATA ANALYSIS: A series of regression models were used to examine associations among the UP-related factors and their relationship to avoidance attitudes toward PLH. PRINCIPAL
FINDINGS: UP training was associated with better knowledge of and adherence to UP and perceived availability of UP supplies in hospitals. UP training, knowledge, and adherence were significantly associated with avoidance attitudes toward PLH in medical practice. Being a nurse was also related to HIV-related avoidance.
CONCLUSION: UP promotion campaigns, including in-service training and reinforcement of UP adherence, could play an important role in the battle against HIV-related avoidance in medical settings. Intervention programs should focus on not only individual providers' attitudes and behaviors but also on structural support for norms shifts in the medical community. © Health Research and Educational Trust.