Ishimaru, T., Wada, K., Arphorn, S., and Smith, D.R. (2018) Willingness to care for blood-borne virus-infected patients in Thailand. Occupational Medicine, 68 (3). pp. 192-198.

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Abstract

Background: Although stigma and discrimination by nurses against patients infected with human immunodeficiency virus (HIV) or hepatitis C virus (HCV) have been reported, potential determinants of nurses’ willingness to care for these patients have not been well studied in Thailand.

Aims: To identify factors associated with Thai nurses’ willingness to care for patients infected with HIV or HCV.

Methods: Multivariable logistic regression analysis of data from a questionnaire completed by nurses at a large hospital in Bangkok, Thailand.

Results: Of 626 nurses, 546 (87%) nurses participated. Eleven per cent (59) and 6% (34) had previously experienced HIV- or HCV-infected blood contamination incidents, respectively. Forty-four per cent (240) and 38% (208) reported unwillingness to care for HIV- or HCV-infected patients, respectively. Willingness to care was less common [adjusted odds ratios 0.51 (0.34–0.74) for HIV and 0.62 (0.42–0.89) for HCV] in nurses aged ≥ 40 years and in those who feared HCV [0.63 (0.37–0.99)], but not HIV [0.84 (0.5–1.26)] transmission. Nurses who had confidence in protecting themselves against infection with HIV [1.84 (1.52–2.04)] and HCV [1.87 (1.45–2.18)], and accepting attitudes towards HIV-infected co-workers [1.39 (1.08–1.66)] but not HCV-infected co-workers [1.16 (0.83–1.5)], were more willing to care for HIV- and HCV-infected patients.

Conclusions: Around 4 in 10 Thai nurses in our sample were unwilling to care for HIV- or HCV-infected patients. Minimizing the risk of nosocomial transmission and improving the public perception of infected individuals may help improve nurses’ willingness to care for such patients, in Thailand or elsewhere.

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