摘要:

Objective:To evaluate the feasibility and effectiveness of a standardized HIV partner notification programme within genitourinary medicine clinics in England.Design:A prospective survey of HIV partner notification activity over a 12-month period.Setting:Nineteen genitourinary medicine clinics in England.Patients and participants:A total of 501 eligible HIV-positive patients (either newly diagnosed or with whom partner notification had not been undertaken previously) seen during the study period.Main outcome measures:The numbers of partners named by patients, and the number of contacts notified, counselled and HIV-tested.Results:Information on overall partner notification activity was obtained by reviewing available medical records of 471 patients; 353 (75%) had discussed partner notification with a health-care worker during the study period and 197 (42%) had undertaken partner notification. Detailed information on outcomes was obtained for only 70 patients who named 158 contacts as being at risk of acquiring HIV. Although 71 (45%) contacts were eventually notified, only 28 were subsequently seen in participating clinics. Almost all contacts (n = 27) requested HIV counselling and testing, and five were diagnosed HIV-positive. Patient referral was the most popular notification method chosen.Conclusions:This study illustrates some of the practical difficulties that limit HIV partner notification within genitourinary medicine clinics. These include health-care workers' misgivings about undertaking partner notification, insufficient locating information to identify contacts, and migration of newly diagnosed patients, which prevents continuity and completion of notification. Nevertheless, HIV partner notification uncovered previously undiagnosed HIV infections. Further work needs to be undertaken in staff training and policy implementation if higher rates of partner notification and outcome measurements are to be achieved.

ISSN:0269-9370    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Objective:To describe the role of spiritual beliefs in HIV-positive patients' end-of-life decisions.Design:Inperson, cross-sectional survey.Setting:An HIV/AIDS floor of an urban, university teaching hospital.Patients:Ninety hospitalized HIV-positive patients.Main outcome measures:Prior discussions about advance directives, possession of a living will (written advance directive), fear of death, professions of hope and purpose in life, religious beliefs and practices, guilt about HIV infection, and perception of HIV as punishment.Results:Of 104 eligible patients, 90 agreed to be interviewed. Twenty-four per cent of patients had discussed their resuscitation status with a physician and 17% possessed a living will; 44% of patients felt guilty about their HIV infection, 32% expressed fear of death, and 26% felt their disease was some form of punishment. Prior discussions about resuscitation status were less likely in those who perceived HIV as punishment (P= 0.009) and more likely in those who believed in God's forgiveness (P= 0.043). A living will was more common in those who prayed daily (P= 0.025) and in those whose belief in God helped them when thinking about death (P= 0.065). Fear of death was more likely in those who perceived HIV as punishment (P= 0.01) or felt guilty about having HIV (P= 0.039), and less likely in those who read the Bible frequently (P= 0.01) or attended church regularly (P= 0.015). Outcome measures did not vary significantly according sex, race, HIV risk factors, or education level.Conclusions:In this HIV-positive population, spiritual beliefs and religious practices appeared to play a role in end-of-life decisions. Discussions about end-of-life decisions may be facilitated by a patient's belief in a forgiving God and impeded by a patient's interpretation of HIV infection as punishment. Health-care providers need to recognize patients' spiritual beliefs and incorporate them into discussions about terminal care.

ISSN:0269-9370    

出版商:OVID    

年代:1998

数据来源: OVID