Influence of HIV-infection risk on resident physicians

To determine the influence of the risk of contracting the human immunodeficiency virus (HIV) on the attitudes and behavior of resident physicians.

A 15-item questionnaire was sent in January 1994 to the 268 residents in the major specialty training programs at the three clinical campuses of the University of Medicine and Dentistry of New Jersey. The residents' responses about HIV were analyzed in light of their specialty, postgraduate-year level, and training location. Z-tests were used to determine the statistical significance of the responses, and Yates corrections were applied to all calculations.

A total of 121 residents (45%) responded. These residents were similar demographically to the non-respondents. Fifty-one of the responding residents (42%, p < .02) reported that they tended to minimize performing invasive procedures on HIV-positive patients. A surprisingly high number-73 (60%, p < .005)-had been tested for HIV. Only 14 had sustained needle-stick injuries. The risk of HIV infection had not appreciably affected the residents' choices of specialty, but it did dampen their enthusiasm for the practice of medicine. It also influenced their choices of training location, with 34 (28%, p < .001) listing HIV as an important factor. Given the hypothetical situation that they themselves were infected with HIV, 89 (75%, p < .001) of the residents reported that they would not terminate their careers, but 70 (61%, p < .005) indicated that they would refrain from performing invasive procedures.

The residents' responses show a high level of emotional stability as well as a practical acceptance of the reality of HIV in the workplace. The impact on resident physicians of HIV requires further attention by medical educators and program directors.