Preventing tuberculosis among HIV-infected persons: a survey of physicians' knowledge and practices

Prev Med. 1999 Apr;28(4):437-44. doi: 10.1006/pmed.1998.0452.


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 to Mycobacterium 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 of M. tuberculosis and HIV.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • AIDS-Related Opportunistic Infections / prevention & control*
  • AIDS-Related Opportunistic Infections / psychology
  • Antibiotic Prophylaxis / statistics & numerical data
  • Antitubercular Agents / therapeutic use
  • California
  • Chi-Square Distribution
  • Clinical Competence*
  • Cohort Effect
  • Health Care Surveys
  • Humans
  • Isoniazid / therapeutic use
  • Medicine / statistics & numerical data
  • Patient Compliance
  • Patient Education as Topic / statistics & numerical data*
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Practice Patterns, Physicians' / trends
  • Professional Practice / statistics & numerical data
  • Specialization
  • Tuberculin Test / psychology
  • Tuberculin Test / statistics & numerical data
  • Tuberculosis / prevention & control*
  • Tuberculosis / psychology


  • Antitubercular Agents
  • Isoniazid