Treatment Risks, Difficulties Foster Young Doctors' Doubts
Young doctors in training, especially men, are increasingly concerned about the risk and difficulty of treating AIDS patients.
According to a study of 250 medical and pediatric residents at two New York hospitals, one-quarter said they would not continue treating AIDS patients if given a choice and about one-third said they should have some say in whether they care for such patients.
Another study, of 56 young doctors at San Francisco General Hospital, found that 69 percent -- 84 percent of the men and 48 percent of the women -- agreed that they are at risk of getting acquired immune deficiency syndrome even if they have no risk factors other than treating patients with the disease.
Thirty percent of the male doctors and 4 percent of the female doctors in the San Francisco study had had bad dreams or nightmares about AIDS.
Researchers offered three possible reasons for the difference in attitudes between male and female doctors. Male heterosexual doctors might be more uneasy with the homosexuality of many AIDS patients, and they might find themselves confronting their own mortality in treating dying patients their own age. Also, women in medicine have traditionally been more comfortable than men with the palliative care of terminally ill patients.
In the New York study, 36 percent of the medical residents and 17 percent of the pediatric residents reported having stuck themselves accidentally with needles possibly contaminated with the AIDS virus.
Both studies were reported at the Third International Conference on AIDS this week.
Increases in Monogamy, Abstention The number of homosexual men abstaining from sex or choosing monogamy has increased sharply since 1984, a nationwide study of thousands of men has found.
Researchers at the AIDS conference said they have followed 4,955 homosexual and bisexual men since April 1984, questioning them every six months about their sexual activities and life styles.
The share of men who reported that they are abstaining from sex increased from 2 percent to 12 percent. Those who said that they are monogamous rose from 12 percent to 28 percent during the past 2 1/2 years of the study.
In general, the men reported a reduction in high-risk behaviors such as sex with unknown partners and anal intercourse without condoms, researchers said.
The study is being conducted by investigators at the Johns Hopkins School of Public Health, three other universities and the National Institutes of Health.
"Despite the marked and continued decrease of risky sexual practices among the men in the study, further reductions are warranted," Robin Fox, a Johns Hopkins researcher, said in a report to the conference. "Safe sex programs must be improved, expanded and sustained."
Infection Rate Higher in Navy, Marines AIDS infections are about twice as common among men in the Navy and Marines as among men in other branches of the armed services, according to statistics released yesterday. Military doctors said this is probably because Navy bases are in parts of the country where AIDS is most common.
The report found that 2.2 of every 1,000 men in the Navy and Marines are infected with the AIDS virus. The rate is 1.1 in the Army and 1.2 in the Air Force. The infection rate for women in the military -- about 0.5 cases per 1,000 -- varies only slightly among the services.
The figures were presented at the AIDS conference by Dr. Donald S. Burke of the Walter Reed Army Institute.
So far, 1.6 million of the military's 2.2 million active-duty personnel have been tested for AIDS-virus infection. Experts have found that 2,522 military people, or 1.6 per 1,000, carry the virus.
Nearly 1 million recruits also have been tested before admission to the service, and their infection rate has been 1.5 per 1,000. Burke said that overall, the AIDS infection rate among recruits appears to be doubling every 10 years. But among blacks, it is doubling every three years.
Military doctors cautioned that their numbers may not reflect the level of AIDS infection among young Americans in general, because some people may not apply for service if they suspect they are infected.
Quick Test for Antibodies Described Du Pont Co. researchers are developing what they say might be the first quick test for antibodies to the AIDS virus.
The test is being designed for use in African countries and has two key advantages over existing tests: It does not require elaborate medical equipment and its chemicals are not sensitive to heat.
In the test, a tiny blood sample is withdrawn and the clear serum is separated from the rest of the blood with a small centrifuge. A small amount of serum is dropped on a pad containing chemicals that react with human AIDS antibodies. After a few minutes, a chemical is added that causes a color change if the antibodies are present.
Preliminary trials show the test has a high accuracy rate, Du Pont researchers said.
If the test proves to be as useful as Du Pont researchers believe, it could also be marketed for use in physicians' offices. -- Don Colburn, Larry Thompson and news service reports