| BackgroundWith the expansion of HIV testing, the chance of exposure to HIV-infected/AIDS persons in clinical medical institutions is gradually increasing. These patients have a long incubation period and various early onset symptoms, and may be diagnosed at any department in hospitals, which can put medical staff in the first line of prevention and treatment of HIV/AIDS in danger, or occupational exposure to HIV. In 2013, CDC released the latest version of AXA’s "occupational diseases’ classification and catalog" with inclusion of AIDS (limited to health staff and the policemen) for the first time. This document is oriented not only to timely and effective treatment of HIV-infected patients, but also eliminating the fear of the medical staff, which reflects the national protection from occupational exposure in medical personnel. Therefore, it is important to understand the knowledge and influencing factors of AIDS and occupational exposure in medical staff and to carry out targeted education and training. This study selected two hospitals in Beijing as study sites to gain a preliminary understanding of the protection knowledge of occupational exposure to HIV and the influencing factors in medical staff.ObjectivesTo learn cognitive situation of HIV/AIDS related health services and the present situation of HIV/AIDS occupational protection knowledge, analyze the influence factors of medical workers’knowledge of HIV/AIDS occupational exposure and provide a basis for HIV/AIDS related training in medical staff.MethodsThis study adopted quantitative research and qualitative research methods. Quantitative survey research included general demographic characteristics, basic knowledge of AIDS, occupational exposure and occupational protection cognition; qualitative research was interviews with targeted respondents about AIDS awareness and occupational protection.Quantitative ResearchA cross-sectional survey by an anonymous filling in the questionnaire independently was conducted. Answering 8 questions or more of the 15 questions of AIDS/HIV-related occupational exposure knowledge correctly is defined as awareness of AIDS and occupational exposure knowledge. And a regression analysis was conducted with awareness of AIDS and occupational knowledge as the dependent variable and gender, age group, job, job title, education, work experience, whether experienced occupational exposure before and whether previously received HIV-related training as independent variables. After conducting univariate analysis with Chi-square test (χ2 test), non-conditional multivariate Logistic regression analysis was conducted, and statistical test standards are α= 0.05. Statistical software SPSS version 19.0 was used.Qualitative ResearchSample of the medical staff of medical institutions are selected for interviews to gain some useful information. The content of interview includes accepting the situation of HIV/AIDS training, awareness of occupational exposure, some obstacles when meeting with HIV patients in medical practice and suggestion to improve the situation. Qualitative survey data were coded classified and checked; and the main points of doctors were summarized.Results1. The survey collected a total of 1163 questionnaires, after excluding unqualified questionnaire for 1077 copies of valid questionnaires. The questionnaire has 92.6% efficiency. The interviewees’mean age was 42 years old, with work experience 15 years on average; 53.1%(572/1077) of the respondents had occupational exposure during the past work; 59.1%(636/1077) of the respondents had received HIV-related training before.2. Among the 1077 valid questionnaires, the proportion of knowing occupational exposure to HIV-related knowledge and awareness was 57.9%(624/1077). On basic HIV/AIDS knowledge such as "What do AIDS and HIV stand for?", "route of transmission of HIV/AIDS", "HIV laboratory confirmatory diagnosis tests", the correct proportion was 77.4%(834/1077),72.7%(783/1077) and 65.4%(704/1077) respectively; The correct proportion of questions of the " treatment measures be taken after occupational exposure to HIV" and "HIV antibody testing time since post-occupational exposure to HIV" was 29.3%(316/1077) and 35.0%, respectively (377/1077).3. To investigate whether occupational exposure to HIV knowledge was associated with patients’gender, age group, job, job title, education, work experience, whether occupational exposure occurred, whether received HIV-related training, x2 test was conducted, As for statistically significant independent variables, multivariate analysis was used. Independent variables such as gender, job and whether have been previous occupational exposure was not statistically significant in univariate analysis; age group was statistically significant in the univariate analysis, but was not statistically significant in the multivariate analysis.4. Interview survey was conducted for 30 medical workers. Eighty percent of the respondents said that they participated in AIDS-related knowledge training; 66.67% of the respondents said the HIV tests were issued to inpatients alone; 93.33% of the respondents said that once they met with HIV-positive patients, patients were recommended to transfer to specialized hospital for treatment, only 6.67% of the respondents believe that doctors should face different types of patients, daily treatment activities to do to the standard of protection, do not worry and fear; 43.33% of the respondents can accurately answer the circumstances under which happens occupational exposure; 40% of respondents know after occupational exposure handler. The main factors affecting the level of education of medical personnel, medical personnel working year is the impact of AIDS and occupational exposure to know the status quo.ConclusionsThe medical personnel have worse awareness of HIV and occupational exposure knowledge. Particular AIDS-related knowledge training on medical workers especially in junior logistics health workers should be strengthened, and the training with depth and breadth on AIDS-related knowledge should be comprehensive and systematic. Medical institutions should establish and improve mechanisms for checking and handling occupational exposure, and strengthen the hospital infection control so as to avoid iatrogenic HIV infection.
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