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AIDS & entrepreneurs.

Recent moves in Congress and the Centers for Disease Control to pressure HIV-infected health care workers either to restrict their practice to noninvasive procedures or to disclose their status to patients may be backfiring. The Medical Expertise Retention Program, a San Francisco advocacy group for HIV-infected doctors, recently conducted a twenty-nine-state poll of 196 doctors, nurses, and dental workers who were either known to be HIV-positive or who were at high risk, to determine their attitudes toward the new federal guidelines and proposed practice limitations. The results are disturbing.

Fifty-five percent of those polled worried that restricting their practices would give patients good grounds to suspect they were infected and sue them. Of those who knew they were infected, 67 percent said they avoided seeking treatment or submitting insurance claims through their place of employment because they feared job discrimination and loss of privacy.

Most telling of all, perhaps, was that 57 percent of those who did not know for sure whether they were infected expressed reluctance to be tested, preferring uncertainty to knowledge that could cost them their jobs. If the survey reflects widespread attitudes, it would seem that the federal policies are having the reverse effect from what was intended, and that they actually discourage health care workers from being tested and from limiting their practice in ways that reduce risk of transmission.

While the professionals in the survey worried about the security of their practice, others have taken federal and state pressure to disclose as an opportunity to attract patients. According to the Washington Post (24 August 1991), Robert A. Bunn, a dentist in Manassas, Va., has taken out quarter-page ads in the Manassas Journal Messenger proclaiming that he and his staff have all tested negative for the virus. The ads go on to note that the dentist and his coworkers will continue to be tested and that anyone testing positive will not be permitted to treat patients. Dr. Bunn told reporters that business has improved "significantly" since the ads started appearing in July.

And in the state where one dentist infected the only five patients known to have received the virus from a health care worker, a Florida businessman has set up the National Free of AIDS Identification Service. For $180 a physician or dentist can get an HIV test and, if the test is negative, a certificate suitable for framing, attesting to that fact. The entrepreneur is planning a nationwide twenty-four-hour information line that patients can call to ascertain the standing of any participating doctor.
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Title Annotation:health care workers and AIDS
Author:Nelson, Hilde L.
Publication:The Hastings Center Report
Date:Nov 1, 1991
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