Survey of healthcare workers in a Midwestern tertiary care center regarding HIV transmission risk and their opinion about HIV positive healthcare workers

Background: Antiretrovirals have changed the prognosis of HIV infection from a death sentence to a manageable chronic condition. However opinions and stigma about this infection are slow to change even among healthcare workers (HCWs). We planned to survey healthcare workers in regards to their knowledge about HIV transmission and prognosis, and their attitude towards HIV positive HCWs (HIV+HCWs).

Methods: A cross-sectional survey was distributed by email using REDCap software in April 2016 to medical personnel at the University of Kansas Medical Center, including attending physicians, fellows, residents, medical students, nurses, nurse practitioners, physician assistants, pharmacists, and technicians. Demographics were collected anonymously followed by questions regarding HIV transmission, prognosis, attitude towards HIV+HCWs. Descriptive statistics from REDCap were used.

Results: We received 826 responses from 5588 individuals (14.8% response) within a period of one month. Respondents were 75.2% female, 88.9% white and 51% nurses. Half were younger than 35 years. Regarding HIV transmission, 49.3% of respondents considered oral sex as high risk whereas medium to high-risk activities included exposure to saliva/spitting (23.2%) and French kissing (38.8%). Blood in contact with intact skin was deemed intermediate risk by 36.7% whereas unprotected sexual intercourse with someone taking HIV medications was considered as low risk by only 9.2%. A third of respondents have never been tested for HIV and 40.8% agreed that all physicians and HCWs should be required to be tested for HIV. Requirement to disclosure HIV status to patients irrespective of risk of transmission got only 5.5% approval. Regarding surgical procedures performed by HIV+HCW, 22.1% would not allow a HIV+ surgeon to electively perform their cholecystectomy and 26.5% would not allow heart surgery; 17.6% declined vaginal delivery and 27.7% declined a C-section if their delivery was performed by an HIV+ physician, and 15% refused allowing an HIV+HCW start their intravenous line. However, 70.9% said they would keep their trusted personal physician or surgeon if they found out they are HIV+.

Conclusion: More education is needed among HCWs about transmission risk of HIV, in order to increase awareness and reduce the stigma associated with this chronic infection.