The role of perceived risk in general practitioners' decisions to inform partners of HIV-infected patients

Abstract

Objectives. To investigate the role of physician and patient characteristics in determining risk perceptions and decision making in a hypothetical case where confidentiality may need to be broken to protect the partner of a patient who is infected with HIV. To identify if risk perceptions mediate the relation between physician and patient characteristics and confidentiality decisions. Design. Analysis of a sample of 207 Irish general practitioners (GPs) randomly assigned to one of four experimental vignette conditions. Methods. A single vignette scenario was presented to each GP within which a hypothetical male HIV patient was depicted as unwilling to disclose his HIV status to his partner. The hypothetical patient's use of protection (used, not used) and sexual orientation (heterosexual, homosexual) were varied systematically. GPs then estimated the risk the patient posed to the partner and the likelihood that they would break confidentiality to inform the partner of the patient's HIV status. Results. Less experienced GPs and those who had broken confidentiality in the past were likely to indicate they would break confidentiality in response to the presented scenario. GPs were more likely to inform the partner when protection was not used during intercourse and when the relationship was heterosexual rather than homosexual. Risk perceptions partially mediated the relationship between the patient's use of protection and confidentiality decision ratings but did not explain the association between GP characteristics or patient sexuality and decision making. Conclusion. Physician background characteristics and HIV patient sexual practice and orientation are associated with hypothetical partner notification decisions. The perceived risk to the partner only partially explained the relation between patient use of protection and decision making.