Is under-reporting of AIDS a problem in Jamaica?

ABSTRACT

A survey of physicians in Jamaica was conducted between March and September, 1993 in order to estimate the level of reporting of HIV and AIDS. A questionnaire was delivered to nearly all of approximately 1,200 physicians practising in Jamaica. Completed questionnaires were received from 518, a response rate of 35 per cent. Of the physicians responding, 46 per cent were in private practice only, 22 per cent in the public sector only and 32 per cent in both. Two-thirds (66 per cent) of the physicians in private practice had not diagnosed a case of AIDS and 65 had not had a patient with a positive HIV test result. Half (54 per cent) of the private physicians had reported all their AIDS cases, 8 per cent had reported some and 38 per cent (45 doctors) had reported none. The main reasons for not reporting were "thought someone else had reported" (15 doctors), concern for confidentiality (11) and not knowing where to report (8). Only 9 per cent of private practitioners were currently seeing an AIDS patient and 12 per cent were seeing an HIV-infected person. Of physicians with current AIDS patients 16 per cent preferred not to report, 21 per cent intended to report and 63 per cent had reported. Nearly one-third (29 per cent) of private practitioners expressed reservations about treating persons with HIV/AIDS. Most (75 per cent) public sector physicians had seen one or more AIDS patients. Sixty-four per cent of these physicians said that all of their AIDS cases were reported, 4 per cent said some, 4 per cent said none and 28 per cent didn't know. Reporting of AIDS cases is better in the public sector than among private physicians. It is likely that some, if not many, of the AIDS cases not reported by private physicians are reported when admitted to hospital. It is not possible to estimate the precise level of under reporting of AIDS in Jamaica from this survey. However, more needs to be done to address the reservations of some private physicians and convince them of the need for timely reporting of HIV/AIDS cases