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Nonoccupational postexposure HIV prevention: emergency physicians' current practices, attitudes, and beliefs.
Ann Emerg Med. 2003 Nov; 42(5):651-6.AE

Abstract

STUDY OBJECTIVE

We surveyed emergency physicians to determine current practices, knowledge, attitudes, and beliefs regarding nonoccupational postexposure prevention practices.

METHODS

Two thousand randomly selected practicing emergency physicians from the American College of Emergency Physicians' national database and all graduating emergency medicine residents in 2000 were surveyed. Knowledge, role responsibility, self-efficacy, and attitudes and beliefs were measured and composite scores developed. Differences in responses between supporters and nonsupporters were compared for each category.

RESULTS

Eight hundred eighty-nine responded, representing 60% (67/113) of emergency medicine residencies, 32% (347/1095) of emergency medicine residents, and 27% (542/2000) of emergency physicians. Responders recommend nonoccupational postexposure prevention for sexual assault (35%), unintentional needle stick (25%), and, rarely (<15%), for unsafe sexual practices and injection drug use. Knowledge of Centers for Disease Control and Prevention recommendations or the time when treatment may be most beneficial is poor (15.5% and 13.7%, respectively). Most agree their role includes providing nonoccupational postexposure prevention drugs and referring patients for counseling (76.5% and 75.6%, respectively). Confidence in assessing need for nonoccupational postexposure prevention varied with exposure type (sexual assault [61.6%], unintentional needle stick [54.8%], unsafe sexual practices [40.4%], and injection drug use [49.7%]). Supporters of nonoccupational postexposure prevention (64.1%) are more likely to have nonoccupational postexposure prevention available (69.3% versus 42.9%; 95% confidence interval [CI] 19.7 to 33.1), written protocols (42.5% versus 33.0%; 95% CI 2.8 to 16.2), and higher mean composite scores than nonsupporters in all categories: knowledge, self-efficacy, role responsibility, and attitudes.

CONCLUSION

Most emergency physicians surveyed agree that offering nonoccupational postexposure prevention is feasible and within their role responsibility. Establishing nonoccupational postexposure prevention protocols and providing educational programs are important first steps in changing practice.

Authors+Show Affiliations

Section of Emergency Medicine, Yale University School of Medicine, New Haven, CT, USA. mccauslandjb@msx.upmc.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

14581917

Citation

McCausland, Julie B., et al. "Nonoccupational Postexposure HIV Prevention: Emergency Physicians' Current Practices, Attitudes, and Beliefs." Annals of Emergency Medicine, vol. 42, no. 5, 2003, pp. 651-6.
McCausland JB, Linden JA, Degutis LC, et al. Nonoccupational postexposure HIV prevention: emergency physicians' current practices, attitudes, and beliefs. Ann Emerg Med. 2003;42(5):651-6.
McCausland, J. B., Linden, J. A., Degutis, L. C., Ramanujam, P., Sullivan, L. M., & D'onofrio, G. (2003). Nonoccupational postexposure HIV prevention: emergency physicians' current practices, attitudes, and beliefs. Annals of Emergency Medicine, 42(5), 651-6.
McCausland JB, et al. Nonoccupational Postexposure HIV Prevention: Emergency Physicians' Current Practices, Attitudes, and Beliefs. Ann Emerg Med. 2003;42(5):651-6. PubMed PMID: 14581917.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nonoccupational postexposure HIV prevention: emergency physicians' current practices, attitudes, and beliefs. AU - McCausland,Julie B, AU - Linden,Judith A, AU - Degutis,Linda C, AU - Ramanujam,Prasanthi, AU - Sullivan,Lisa M, AU - D'onofrio,Gail, PY - 2003/10/29/pubmed PY - 2004/1/6/medline PY - 2003/10/29/entrez SP - 651 EP - 6 JF - Annals of emergency medicine JO - Ann Emerg Med VL - 42 IS - 5 N2 - STUDY OBJECTIVE: We surveyed emergency physicians to determine current practices, knowledge, attitudes, and beliefs regarding nonoccupational postexposure prevention practices. METHODS: Two thousand randomly selected practicing emergency physicians from the American College of Emergency Physicians' national database and all graduating emergency medicine residents in 2000 were surveyed. Knowledge, role responsibility, self-efficacy, and attitudes and beliefs were measured and composite scores developed. Differences in responses between supporters and nonsupporters were compared for each category. RESULTS: Eight hundred eighty-nine responded, representing 60% (67/113) of emergency medicine residencies, 32% (347/1095) of emergency medicine residents, and 27% (542/2000) of emergency physicians. Responders recommend nonoccupational postexposure prevention for sexual assault (35%), unintentional needle stick (25%), and, rarely (<15%), for unsafe sexual practices and injection drug use. Knowledge of Centers for Disease Control and Prevention recommendations or the time when treatment may be most beneficial is poor (15.5% and 13.7%, respectively). Most agree their role includes providing nonoccupational postexposure prevention drugs and referring patients for counseling (76.5% and 75.6%, respectively). Confidence in assessing need for nonoccupational postexposure prevention varied with exposure type (sexual assault [61.6%], unintentional needle stick [54.8%], unsafe sexual practices [40.4%], and injection drug use [49.7%]). Supporters of nonoccupational postexposure prevention (64.1%) are more likely to have nonoccupational postexposure prevention available (69.3% versus 42.9%; 95% confidence interval [CI] 19.7 to 33.1), written protocols (42.5% versus 33.0%; 95% CI 2.8 to 16.2), and higher mean composite scores than nonsupporters in all categories: knowledge, self-efficacy, role responsibility, and attitudes. CONCLUSION: Most emergency physicians surveyed agree that offering nonoccupational postexposure prevention is feasible and within their role responsibility. Establishing nonoccupational postexposure prevention protocols and providing educational programs are important first steps in changing practice. SN - 0196-0644 UR - https://www.unboundmedicine.com/medline/citation/14581917/Nonoccupational_postexposure_HIV_prevention:_emergency_physicians'_current_practices_attitudes_and_beliefs_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S019606440300338X DB - PRIME DP - Unbound Medicine ER -