Surgery Today

, Volume 42, Issue 11, pp 1066–1070 | Cite as

The attitudes of British surgical trainees about the treatment of HIV-infected patients

Original Article
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Abstract

Purpose

As the incidence of HIV increases, the occupational risk of human immuno deficiency virus (HIV) infection also increases, leading to heightened anxiety within surgical practice. This study assessed the attitudes of surgeons treating HIV-infected patients.

Methods

Seventy surgical trainees working in two district general hospitals were requested to complete a survey assessing their attitudes regarding the surgical management of HIV-infected patients.

Results

A needle-stick injury was reported by 64% of the trainees. Fifty-four percent of trainees were concerned about acquiring HIV from patients when performing a surgical procedure. There was a significant difference between the number of trainees worried about treating a patient with HIV and the number of trainees wearing eye protection when performing invasive procedures (p < 0.002). Eighty-six percent of trainees were confident they could treat HIV patients safely, but only 63% were aware of the hospital protocol for needle-stick injuries.

Conclusion

There appears to be increasing concern among surgical trainees about carrying out surgical procedures on HIV-infected patients. Despite equipment being fully available, many trainees are not considering the full use of protective theatre garments to minimize the risk of HIV contamination. Further education and training is required to stress the importance of the increasing HIV prevalence and the need for safety during surgical practice.

Keywords

HIV Surgical training AIDS British trainees 

References

  1. 1.
    Joint United Nations Programme on HIV/AIDS (UNAIDS) and World Health Organization (WHO). AIDS epidemic update: November 2009; http://www.unaids.org/en/KnowledgeCentre/HIVData/EpiUpdate/EpiUpdArchive/2009/default.asp (Accessed, 16th January 2010).
  2. 2.
    Obalum DC, Eyesan SU, Ogo N, Enweani UN, Ajoku JO. Concerns, attitudes, and practices of orthopaedic surgeons towards management of patients with HIV/AIDS in Nigeria. Int Orthop. 2009;33:851–4.PubMedCrossRefGoogle Scholar
  3. 3.
    Lowenfels AB, Wormeser GP, Ramesh J. Frequency of puncture injuries in surgeons and estimated risk of HIV infection. Arch Surg. 1989;124:1284–6.PubMedCrossRefGoogle Scholar
  4. 4.
    Palmer JD, Rickett JW. The mechanisms and risk of surgical glove penetration. J Hosp Infect. 1992;22:279–86.PubMedCrossRefGoogle Scholar
  5. 5.
    Reis C, Heisler M, Amowitz LL, Moreland RS, Mafeni JO, Anyamele C, Iacopino V. Discriminatory attitudes and practices by health workers toward patients with HIV/AIDS in Nigeria. PLoS Med. 2005;2:743–52.CrossRefGoogle Scholar
  6. 6.
    Chen WT, Han M, Holzemer WL. Nurses’ knowledge, attitudes, and practice related to HIV transmission in Northeastern China. AIDS Patients Care STDs. 2004;18:417–22.CrossRefGoogle Scholar
  7. 7.
    Juan CW, Siebers R, Fu-Sheng Wu FF, Chang YJ, Chao C. The attitudes, concerns, gloving practices and knowledge of nurses in a Taiwanese hospital regarding AIDS and HIV. Int J Nurs Practice. 2004;10:32–8.CrossRefGoogle Scholar
  8. 8.
    Naidoo P. Barriers to HIV care and treatment by doctors: a review of the literature. SA Farm Pract 2006; 48:55–16e.Google Scholar
  9. 9.
    Osborn EH, Papadakis MA, Gerberding JL. Occupational exposures to body fluids among medical students. A seven-year longitudinal study. Ann Intern Med. 1999;130:45–51.PubMedGoogle Scholar
  10. 10.
    Obi SN, Waboso P, Ozumba BC. HIV/AIDS: occupational risk, attitude and behaviour of surgeons in southeast Nigeria. Int J STD AIDS. 2005;16:370–3.PubMedGoogle Scholar
  11. 11.
    Ducan V, Agalar F, Sayek I. Surgeons’ attitudes toward HIV/AIDS in Turkey. Aids Care. 2001;13:243–50.CrossRefGoogle Scholar
  12. 12.
    Mc Carthy ML, Bosse MJ, Preas MA, De Long WG, Gunther SF, Moed BR. Orthopaedic Trauma surgeons’ attitudes and practices towards bloodborne pathogens. J Orthop Trauma. 1996;10:383–8.CrossRefGoogle Scholar
  13. 13.
    Suttie SA, Robinson S, Ashcroft GP, Hutchison JD. Current practice in the management of high-risk orthopaedic trauma patients in Scotland. Injury Extra. 2005;36:59–63.CrossRefGoogle Scholar
  14. 14.
    Geberding JL, Littell C, Tarkington A, Brown A, Schecter WP. Risk of exposure of surgical personnel to patients’ blood during surgery at San Francisco General Hospital. N Engl J Med. 1990;322:1788–93.CrossRefGoogle Scholar
  15. 15.
    Jagger J, Bentley M, Tereskerz P. A study of patterns and prevention of blood exposure in OR personnel. AORN J. 1998;67:979–96.PubMedCrossRefGoogle Scholar
  16. 16.
    Quebbeman EJ, Telford GL, Hubbard S, Wadsworth K, Hardman B, Goodman H, Gottlieb MS. Risk of blood contamination and injury to operating room personnel. Ann Surg. 1991;214:614–20.PubMedCrossRefGoogle Scholar
  17. 17.
    Tschachler E, Groh V, Popovic M, Mann DL, Konrad K, Safai B, et al. Epidermal langerhans cells—a target for HTLV-III/LAV infection. J Invest Dermatol. 1987;88:233–7.PubMedCrossRefGoogle Scholar
  18. 18.
    Chou L, Reynolds MR, Esterhai JL. Hazards to the orthopaedic trauma surgeon: occupational exposure to HIV and viral hepatitis A. J Orthop Trauma. 1996;10:289–96.PubMedCrossRefGoogle Scholar
  19. 19.
    Marin-Bertolin S, Gonzalez-Martinez R, Nieria Gimenez C, Marquina Vila P, Amorrortu-Velayos J. Does gloving protect surgical staff from skin contamination during plastic surgery? Plast Reconstr Surg. 1997;99:956–60.PubMedCrossRefGoogle Scholar
  20. 20.
    Patterson JM, Novak CB, Mackinnon SE, Patterson GA. Surgeons’ concern and practices of protection against bloodborne pathogens. Ann Surg. 1998;228:266–72.PubMedCrossRefGoogle Scholar
  21. 21.
    Moghimi M, Marashi SA, Kabir A, Taghipour HR, Faghihi-Kashani AH, Ghoddoosi I, et al. Knowledge, attitude, and practice of iranian surgeons about blood-borne diseases. J Surg Res. 2009;151:80–4.PubMedCrossRefGoogle Scholar
  22. 22.
    Leonas KK, Jinkins RS. The relationship of selected fabric characteristics and the barrier effectiveness of surgical gown fabrics. Am J Infect Control. 1997;25:16–23.PubMedCrossRefGoogle Scholar
  23. 23.
    Rhodes RS. Hepatitis B virus, surgeons and surgery. Bull AM College Surg. 1995;80:30–42.Google Scholar
  24. 24.
    Stotter AT, Vipond MN, Guillour PJ. The response of general surgeons to HIV in England and Wales. Ann R Coll Surg Engl. 1990;72:281–6.PubMedGoogle Scholar
  25. 25.
    Miles AJG, Wastell C, Allen-Mersh TG. Protection for the left index finger whilst operating on HIV positive patients. Ann R Coll Surg Engl. 1989;71:225.PubMedGoogle Scholar
  26. 26.
    Prüss-Üstün A, Rapiti E, Hutin Y. Estimation of the global burden of disease attributable to contaminated sharps injuries among health-care workers. Am J Ind Med. 2005;48:482–90.PubMedCrossRefGoogle Scholar
  27. 27.
    Makary MA, Al-Attar A, Holzmueller CG, Sexton JB, Syin D, Gilson MM, et al. Needlestick injuries among surgeons in training. N Engl J Med. 2007;356:2693–9.PubMedCrossRefGoogle Scholar
  28. 28.
    Kennedy R, Kelly S, Gonsalves S, Mc Cann PA. Barriers to the reporting and management of needlestick injuries among surgeons. Ir J Med Sci. 2009;178:297–9.PubMedCrossRefGoogle Scholar
  29. 29.
    Adebamaowo CA, Ezeome ER, Ajuwon JA, Ogundiran TO. Survey of the knowledge attitude and practice of Nigerian surgery trainees to HIV infected persons and AIDS patients. BMC surg. 2002;2:7.CrossRefGoogle Scholar
  30. 30.
    Faris R, Shouman AJ. Study of the knowledge, attitude of Egyptian health care workers towards occupational HIV infection. Egypt Public Health Assoc. 1994;69:115–28.Google Scholar
  31. 31.
    Kelen GD, Fritz S, Qaqish B, Brookmeyer R, Baker JL, Kline RL, et al. Unrecognized human immunodeficiency virus infection in emergency department patients. N Engl J Med. 1988;318:1645–50.PubMedCrossRefGoogle Scholar

Copyright information

© Springer 2011

Authors and Affiliations

  1. 1.University of ManchesterManchesterUK
  2. 2.Department of Plastic SurgeryWhiston General HospitalLiverpoolUK

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