[A survey comparing the route of HIV transmission reported by patients to their physicians and the self-reported "actual route"].

ABSTRACT

OBJECTIVES: To clarify the proportion of HIV patients who inform their physicians of the actual route of transmission and the factors related to non-disclosure in order to improve conditions to support open disclosure in healthcare settings. METHODS: We conducted an anonymous self-completed online questionnaire between September and December 2010 of people with HIV. The data from 237 subjects living in Japan were analyzed. To identify factors causing patients to not be truthful to their physicians, odds ratios and confidence intervals (CIs) were calculated, with "discrepancy between the actual route of HIV transmission and the route reported to the physician' as a dependent variable, and sex, age, residential area, route of transmission, presence or absence of consent to undergo HIV testing, time since being diagnosed as infected with HIV, and favorability of physician responses as independent variables. RESULTS: The proportions of patients who had informed their physicians of actual and false routes of HIV transmission were 75.1% and 17.7%, respectively. Among subjects reporting homosexual contact, 97.5% reported the actual route. On the other hand, among subjects reporting heterosexual contact, only 64.3% reported the actual route while 28.6% actually had homosexual contact. Furthermore, 47.4% of the subjects who reported their routes of HIV transmission as sexual contact, but did not disclose whether the contact had been homosexual or heterosexual, actually had homosexual contact. On comparing subjects who had evaluated responses from their physicians favorably and unfavorably, the proportion of those reporting a false route of transmission was significantly higher in the latter group, with the odds ratio being 2.51 (95% CI 1.26-5.01). CONCLUSION: AIDS Surveillance Committee reports of HIV and AIDS cases attributed to a homosexual route of infection may be lower than actual numbers. The most common factor related to non-disclosure was the perception of unfavorable responses from physicians; improvements to support open disclosure are thus needed.