Do nurses avoid AIDS patients? Avoidance behaviours and the quality of care of hospitalized AIDS patients

To examine whether AIDS patients are stigmatized by nurses providing their care a study was conducted with 100 matched AIDS and general medical (GM) patients in two university and two community hospitals. Quality of care and avoidance behaviours were measured by direct, systematic observation during a concurrent 12-hour period. Stigmatizing attitudes of nurses were measured using standardized instruments of homophobia, fear of AIDS and attitudes toward illicit drug use. Nurses made more eye contact and touched AIDS patients more frequently then GM patients, however these differences did not reach the level of statistical significance They spent significantly more time with AIDS patients (W = 3134.0, p = 0.012). Whether or not nurses were fearful of HIV infection, were homophobic or held negative feelings about drug use made no difference in the level of care provided to AIDS patients, but did for GM patients. However, avoidance behaviours were associated with lower quality of care across all patients regardless of diagnosis. Hierarchical regression models demonstrated that increased time spent with patients and higher percentage positive of verbal mannerisms were associated with an increase in the quality of patient care. Provision of physical care showed the least amount of variation between patients in general. It was concluded that nurses' attitudes had no impact on whether or not AIDS patients were shunned by nurses. The provision of psychosocial care showed the greatest variation and seemed more sensitive to individual nurses' attitudes. The quality of care received by the overwhelming majority of patients could only be termed adequate. Nurses exhibited the greatest caution when performing procedures with patients whose HIV status was unknown. The AIDS population studied were mostly well-educated, homosexual men. Whether these results would be replicated with a different population of patients is as yet unknown.