HBV/HIV+: General dental practitioners' knowledge, attitudes and behaviours

Abstract

A postal survey using a whole population sample of 74 general dental practitioners (GDPs) was carried out in Barnsley. GDPs were questioned about three specific areas of their work in respect of HBV/HIV+ infection control: (a) their levels of knowledge about infection transmission, (b) their attitudes about general infection control and in particular, patients known to be HBV/HIV+ and (c) their practice and behaviours in the everyday working environment.

This information was viewed in the light of specific health promotion models known as Knowledge, Attitudes and Practice (KAP). KAP is based on the assumption that giving knowledge necessarily precedes attitude change, which in turn effects behavioural change and informed decision making.

In order to test any association between clinical knowledge and behaviours, a null hypothesis was developed: “Dentists having ‘greater knowledge’ of HIV infection and transmission would be no more likely than dentists having ‘lesser knowledge’ to adopt positive attitudes and behaviours towards infection control and patients”. Generally, levels of transmission knowledge were high but there was uncertainty over bodily fluids as vectors.

Behavioural practice tended to reflect concerns not necessarily highlighted in practitioners' knowledge base, but was influenced by personal risk perception. The need for practitioners to establish a 'thorough medical history' of the patient was influenced by patient disclosure about their current HBV/HIV+ status. Attitudinal questions highlighted a number of concerns, often involving the tensions between legal and professional constraints and their impact upon everyday practice. The hypothesis was supported, highlighting the weakness of KAP models of health education/health promotion.

Key words:

• HIV+
• HBV
• infection control
• dental practice
• attitudes
• behaviours