Preventing Tuberculosis among HIV-Infected Persons: A Survey of Physicians' Knowledge and Practices

doi:10.1006/pmed.1998.0452

Preventive Medicine

Volume 28, Issue 4, April 1999, Pages 437-444

https://doi.org/10.1006/pmed.1998.0452 Get rights and content

Abstract

Background.Guidelines exist for screening, diagnosing, and preventing tuberculosis (TB) among HIV-infected persons, but their application and utility are unknown.

Methods.We conducted a survey of knowledge and practices among 1,300 physicians in the San Francisco Bay area to assess their practices towards TB among HIV-infected persons.

Results.Of 630 respondents, 350 (56%) provided care for HIV-infected persons. Thirty-four percent of the respondents had seen the most recent guidelines for preventing tuberculosis among HIV-infected persons; 65% routinely provide information to HIV-infected patients about the risks of exposure toMycobacterium tuberculosis; 39% provide annual tuberculin skin testing (TST) to HIV-infected patients without a history of a positive test; 86% knew that ≥5-mm induration is considered a positive TST result in HIV-infected persons; and 47% provide a 12-month regimen of chemoprophylaxis for HIV-infected persons who have a positive TST but not active tuberculosis. Physician specialty and experience with HIV-infected persons were not strongly correlated; experience was a better predictor of correct knowledge and practices.

Conclusions.Many physicians were not aware of the standards of care for preventing tuberculosis among HIV-infected patients, even in a geographic area with a high prevalence ofM. tuberculosisand HIV.

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^☆: The list of physicians was provided by the California Emerging Infections Program. The Tuberculosis Control Branch of the California Department of Health Services assisted with the mailing of letters to physicians. The project was initiated and analyzed by the investigators.

^☆☆: This work was funded by the AIDS Clinical Research Center, University of California, San Francisco, and the John P. Dowdle Endowment to the School of Public Health, University of California, Berkeley.

²: To whom correspondence and reprint requests should be addressed at Division of Public Health Biology and Epidemiology, School of Public Health, 140 Warren Hall, University of California, Berkeley, CA 94720-7360. Fax: (510) 643-5163. E-mail:[email protected].

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Regular ArticlePreventing Tuberculosis among HIV-Infected Persons: A Survey of Physicians' Knowledge and Practices☆,☆☆

Abstract

J Clin Epidemiol

Tubercle Lung Dis

Chest

Lancet

Lancet

Am J Respir Crit Care Med

MMWR

The challenge of defining and counting generalist physicians: an analysis of Physician Masterfile data

Am J Public Health

FoxPro: Version 2.6

Stata statistical software: Release 5.0

Long term risk of tuberculosis among foreign-born persons in the United States

JAMA

Overseas screening for tuberculosis in immigrants and refugees to the United States: current status

Clin Infect Dis

The epidemiology of tuberculosis among foreign-born persons in the United States, 1986–1993

N Engl J Med

Reliability of anergy skin testing in persons with HIV infection

Am J Respir Crit Care Med

A prospective study of the risk of tuberculosis among HIV-infected patients

AIDS

Regular Article
Preventing Tuberculosis among HIV-Infected Persons: A Survey of Physicians' Knowledge and Practices☆,☆☆