Factors associated with refusal to treat HIV-infected patients: the results of a national survey of dentists in Canada

Am J Public Health. 1999 Apr;89(4):541-5. doi: 10.2105/ajph.89.4.541.


Objectives: This study investigated dentists refusal to treat patients who have HIV.

Methods: A survey was mailed to a random sample of all licensed dentists in Canada, with 3 follow-up attempts (n = 6444). Data were weighted to allow for probability of selection and nonresponse and analyzed with Pearson's chi 2 and multiple logistic regression.

Results: The response rate was 66%. Of the respondents, 32% had knowingly treated HIV-infected patients in the last year; 16% would refuse to treat HIV-infected patients. Respondents reported willingness to treat HIV-infected patients (81%), injection drug users (86%), hepatitis B virus-infected patients (87%), homosexual and bisexual persons (94%), individuals with sexually transmitted disease(s) (94%), and recipients of blood and blood products (97%). The best predictors of refusal to treat patients with HIV were lack of ethical responsibility (odds ratio = 9.0) and items related to fear of cross-infection or lack of knowledge of HIV.

Conclusions: One in 6 dentists reported refusal to treat HIV-infected patients, which was associated primarily with respondents' lack of belief in an ethical responsibility to treat patients with HIV and fears related to cross-infection. These results have implications for undergraduate, postgraduate, and continuing education.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Attitude of Health Personnel
  • Canada
  • Cross Infection / prevention & control
  • Dentists / psychology*
  • Dentists / statistics & numerical data*
  • Ethics, Dental
  • Fear
  • Follow-Up Studies
  • HIV Infections / therapy*
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Logistic Models
  • Middle Aged
  • Moral Obligations
  • Odds Ratio
  • Predictive Value of Tests
  • Refusal to Treat / statistics & numerical data*
  • Risk Factors
  • Surveys and Questionnaires