Survey on attitudes toward HIV-infected individuals and infection control practices among dentists in Mexico City

Healthcare workers’ knowledge and attitudes towards sterilization and reuse of medical devices in primary and secondary care public hospitals in Nepal: A multi-centre cross-sectional survey

Background

Healthcare facilities reprocess and sterilize reusable medical devices before each invasive clinical procedure, such as surgery, to prevent person-to-person or environmental transmission of pathogens through medical devices. We conducted a nationwide multi-centre cross-sectional survey in primary and secondary-care public hospitals in Nepal to assess the knowledge and attitudes of healthcare workers towards sterilization and reuse of medical devices.

Methods

We carried out a multi-centre cross-sectional survey comprising eleven primary-care (two district-level and nine district hospitals) and two secondary-care (zonal hospitals) public hospitals which covered all seven provinces of Nepal. Survey questionnaires were distributed to 234 healthcare workers including doctors, nurses, paramedics, and office assistants (involved in medical device reprocessing); 219 (93.6%) returned the completed questionnaire. Descriptive analyses of demographic information, knowledge and attitude responses of survey participants were performed. Logistic regression and ordinal regression models for complex samples were used to investigate associations between responses and independent variables.

Results

Except for a few areas, more than 70% of healthcare workers had proper knowledge about different aspects of sterilization and reuse of medical devices. Paramedics and office assistants were less likely to have the correct knowledge in different aspects compared to nurses. Permanent staff were more likely to give correct answers to some knowledge questions compared to temporary staff. Previous infection control training was positively associated with correct responses to some knowledge items. Most of the healthcare workers had positive attitudes towards different aspects of sterilization and reuse of medical devices, and nurses were more likely to have positive attitudes compared with other staff categories.

Conclusions

Most of the healthcare workers had correct knowledge and positive attitudes towards most areas of sterilization and reuse of medical devices. However, they need proper education and training in some areas such as sterilization procedures, storage of sterilized devices, prion decontamination and standard precautions.

(A1) Identification of Oral Health Care Needs in Children and Adults, Management of Oral Diseases

The workshop considered five questions reviewing the identification of international oral health care needs of children and adults, and the management of oral diseases in resource-poor countries: (1) What is the role of the dental profession in the management of the HIV-infected individual? (2) Identifying health care needs-What are the epidemiology and disparities of HIV-associated oral lesions in children from different continents? (3) How effective is HIV treatment in controlling oral diseases? (4) Could we develop basic inexpensive oral and dental care protocols for economically deprived HIV-infected patients? and (5) What is the best method of arranging resources to meet the oral health care needs of people with HIV disease? The consensus of the workshop participants was that there is a need to re-target research efforts to non-established market economy countries and prioritize research in these regions to children with HIV disease. It will be important to assess commonalities and variations in oral health needs across geographical and cultural boundaries, and research efforts should be centralized in resource-poor countries to support multi-center longitudinal standardized studies. It is essential that oral health research be integrated into other health care research programs, to make these research priorities and public health initiatives feasible.

Assessment of Knowledge, Attitudes, and Practices Regarding Isolation Precautions Among Iranian Healthcare Workers

We conducted a survey of 1,048 healthcare workers (HCWs) at 8 Iranian hospitals regarding knowledge, attitudes, and practices related to isolation precautions. We found 75% below acceptable safety levels. Routine handwashing before and after glove use was reported by fewer than half of the HCWs.

Musculoskeletal disorders amongst Greek endodontists: a national questionnaire survey

AIM

To investigate amongst Greek endodontists the prevalence and characteristics of musculoskeletal disorders (MSDs) in the past 12 months, the treatment followed, their postures during practice and the adoption of ergonomic standards.

METHODOLOGY

One hundred and forty-seven endodontists met the inclusion criteria and were invited to participate in the survey. Participants were asked for personal/professional data, prevalence, characteristics and treatment for MDSs in the past 12 months. Endodontists' postures during practice as well as ergonomic factors were also recorded. Data were analysed using chi-square test, independent samples t-test and logistic regression. The level of significance was set at P = 0.05.

RESULTS

The response rate was 84%. MSDs were reported by 61% of the participants. Of them, 69% reported pain to more than one body part. The prevalence of disorders was highest in the lower back (30%) and neck (30%). Medical care was applied in 53% of the disorders. A sitting position was always used by 83% of endodontists. Awkward postures during practice (OR:4.561, 95% CI:1.341-15.512), regular stretching exercises (OR:0.032, 95% CI:0.010-0.110) and number of patients day(-1) (OR:3.524, 95% CI:1.686-18.100) were significant predictors for MSDs. Properly adjusted stools, sufficient lighting and space in the operating room were reported by 71%, 96% and 93% of participants, respectively.

CONCLUSIONS

A high percentage of endodontists reported MSDs. Adoption of correct/neutral postures, regular performance of stretching exercises and reduced number of patients/day were associated with a low prevalence of disorders. The majority of endodontists had adopted ergonomic innovations/standards to control disorders.

Biossegurança e odontologia: crenças e atitudes de graduandos sobre o controle da infecção cruzada

Este estudo teve o objetivo de investigar as percepções de graduandos de Odontologia sobre a fidelidade às diretrizes de biossegurança e acerca do preservar-se. Nove questões abertas, que abordaram aspectos de interesse para o tema, foram aplicadas em entrevista com 14 acadêmicos, que realizavam atendimento odontológico de pacientes da Faculdade de Odontologia de Araraquara da Unesp. Utilizou-se a metodologia de pesquisa qualitativa e a estratégia metodológica para análise das entrevistas foi a Discurso do Sujeito Coletivo (DSC). Três figuras metodológicas foram obtidas, sendo ideias-centrais, expressões-chave e o DSC propriamente dito. A análise dos discursos permitiu avaliar a fala natural da coletividade. Verificou-se a adesão dos entrevistados aos protocolos de biossegurança, embora houvesse a queixa de que, na rotina diária, as precauções fossem negligenciadas por não serem muito práticas. Entre as medidas de proteção individual e coletiva, rotineiramente utilizadas, foram apontados o uso de Equipamento de Proteção Individual (EPI) e as barreiras protetoras, bem como as atividades de desinfecção e esterilização. O risco de contágio foi visto por alguns com pavor e por outros com total indiferença porque acreditavam ser algo do qual é possível de se ter controle por meio da adesão às precauções padrão. Entre as doenças de maior preocupação, a aids e as hepatites B e C foram as mais temidas. Diante do discurso obtido, salienta-se a necessidade de se aperfeiçoar as estratégias educacionais, com intuito de motivar a fiel adesão às normas de biossegurança, essenciais no trato de pacientes odontológicos.

Dental Infection Control in India at the Turn of the Century

The purpose of this study was to assess the status of Dental Infection Control and Occupational Safety in India. 456 respondents (dentists) used this self-administered survey instrument containing about 96 variables. Over 95% of respondents felt that HIV and Hepatitis were infectious disease risks of concern and that infectious diseases were on the rise in India. Education and training in Dental Safety were lacking and that the latter are made mandatory in dental school curricula. Availability and access to safety materials and equipment were lacking in India and affordability was an issue. While respondents had adequate knowledge in the subject of infectious diseases, attitude (Stigma) towards treating infected patients was a negative factor with a significant number stating that double gloving was necessary, medical history dictated additional precautions and finally that care providers had the right to refuse care to Infectious patients. Although standards in Dental Safety are in place, implementation of educational (both didactic in schools and continuing education for practitioners) is a priority. Dental industry from within and outside India must play a role in this effort. In conclusion, significant structural and educational support activities are indicated with improvements in access and availability of materials and equipment to improve dental safety in India. Further, stigma of infectious diseases must be eradicated if not reduced towards infectious patients.

Perceived knowledge of blood-borne pathogens and avoidance of contact with infected patients

PURPOSE

To examine the relationship between nurses' knowledge of blood-borne pathogens (BBPs), their professional behavior regarding handwashing, compliance with standard precautions (SPs), and avoidance of therapeutic contact with BBP-infected patients.

DESIGN

This cross-sectional design study took place in a regional medical center in Central Israel during 2003.

METHODS

Of the 180 participants, 159 (88.3%) were women with an average educational level of 16.40 years (SD=2.66). The mean age of the sample was 39.41 (SD=10.1). Data were collected using a structured questionnaire including sociodemographic information, level of knowledge concerning three BBPs (human immunodeficiency virus [HIV], hepatitis B virus [HBV], and hepatitis C virus [HCV]), level of compliance with SPs, understanding of SP principles, and avoidance of therapeutic contact with BBP-infected patients.

FINDINGS

Levels of HIV-related knowledge were significantly higher than were those of HBV- and HCV-related knowledge. Only 96 participants (54.5%) stated that all patients should be treated as BBP-carriers. The understanding of the basic principle of SPs did not influence the relationship between perceived knowledge and self-reported compliance with SPs; 77.3% of the sample reported that they avoid therapeutic contact with BBP-infected patients. The level of perceived knowledge did not contribute to the nurses' avoidance of care of BBP carriers.

CONCLUSIONS

Perceived knowledge of BBPs has a weak effect on compliance with SPs and willingness to care for BBP-infected patients.

RECOMMENDATIONS

Nurses must identify their preconceptions when caring for BBP-carriers. Further research on this issue is needed to attempt to understand the forces acting on our nursing staff, in order to ensure appropriate care of BBP-infected patients.

CLINICAL RELEVANCE

Our study indicated some reluctance among nurses to care for patients with blood-borne pathogens. This appears to be the result of value systems and not a lack of knowledge, indicating a need to integrate a psychoeducational approach to education of nurses.

Professional risk, knowledge, attitudes and practice of health care personnel in Serbia with regard to HIV and AIDS

The aim of our investigation was to assess HIV/AIDS-related professional risk, knowledge, attitude and practice of health care workers in Nis. A cross-sectional study of health personnel from Primary Health Centre, Clinical Medical Centre and Dental Clinic in Nis was performed. The data were collected by an anonymous questionnaire. Mantel-Haenszel X2 testing and multiple logistic regression analysis were applied. Results show that 89% of health personnel perceived high professional risk of acquiring HIV infection. The risk perception of acquiring HIV infections was higher among those who were frequently exposed to patients' blood and other body fluids (OR = 10.1 95% CI = 3.1-32.5), and those who had treated HIV-positive patients (OR = 3.0 95% CI = 1.0-8.8). The majority of respondents had insufficient knowledge about the modes of HIV transmission. Nearly two thirds of health personnel agreed that every hospitalized patient should be tested for HIV, and more than four fifths of them agreed that their personal protection was more important than the confidentiality of patient's HIV/AIDS status. Twenty nine percent of health personnel use adequate protection during their daily work with patients. These findings indicated a need for urgent educational and training initiatives of HIV and AIDS for all categories of health care workers.

Physicians' and nurses' views on infected health care workers

This study investigated 204 doctors' and nurses' perceived knowledge of bloodborne pathogens and their attitudes towards bloodborne pathogen-infected health care workers. A structured questionnaire examined: (1) their perceived knowledge of bloodborne pathogens; (2) their attitudes towards bloodborne pathogen-infected personnel; and (3) their opinions on limitation of employment of bloodborne pathogen-infected personnel and restrictions on performing clinical procedures. The levels of HIV-related knowledge were significantly higher than for hepatitis C and B viruses. Although the participants demonstrated more positive attitudes towards hepatitis C- and B-infected health care workers, 64% recommended restricting infected personnel from performing invasive procedures. Attitudes were negatively correlated with opinions on restricting infected personnel from health care work or limiting their involvement in clinical activities. This study highlights the need to formulate a policy to cope with the professional and moral dilemmas related to infected health care workers employed in hospitals, especially for those involved in invasive procedures.

An audit of healthcare workers' knowledge of meticillin resistant Staphylococcus aureus (MRSA) against current infection control standards

The aim of this audit was to establish the knowledge of different healthcare workers regarding meticillin resistant Staphylococcus aureus (MRSA) infection control precautions within the clinical environment. Data was interpreted to identify how education could be appropriately targeted to enhance the knowledge of all staff.

A cross-sectional audit tool was developed from existing policies and national guidelines. Stratified random sampling was undertaken and 961 audits were distributed proportionately to differing groups of healthcare workers from within one UK NHS hospital; 411 audits were returned giving a 43% response rate.

The majority of staff (71%) felt that MRSA is a very serious issue. The amount of staff that had read the trust's MRSA policy or received any formal MRSA education varied considerably, depending on the healthcare worker's occupation, and it was predominantly the nursing staff who had read the MRSA policy. It was unexpected, but encouraging, to find that unregistered nurses (healthcare assistants) and doctors had received the most education regarding MRSA. Of concern was that the majority of hotel services staff (69%) had not read the policy or received any MRSA education (79%). Only medical staff felt they had received adequate amounts of education on MRSA.

Knowledge, attitudes, and practice of iranian dentists with regard to HIV-related disease

Of 369 registered dentists in Fars province in Iran, 309 (83.7%) responded to a survey regarding knowledge, attitudes, and practices related to human immunodeficiency virus (HIV) infection. The level of knowledge was low and was correlated with years in practice, hours worked per week, and whether additional work in a governmental dental office was performed; only the last was significantly associated with adherence to relevant infection control recommendations.

Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome

There exist few studies in the United States that examine the knowledge, attitudes, and beliefs of registered nurses regarding persons with human immunodeficiency virus and acquired immune deficiency syndrome. This information is needed to determine curriculum changes and continuing education needs.

Risk perception and attitudes towards HIV in Serbian health care workers

BACKGROUND

Health care workers (HCWs) are at risk of occupational exposure to human immunodeficiency virus (HIV).

AIM

To investigate the perception of professional risk from, and the knowledge, attitudes and practice of HCWs to HIV and AIDS in Serbia.

METHODS

Cross-sectional study of 1,559 Serbian HCWs using self-administered anonymous questionnaires. Chi-square testing and multiple logistic regression analysis were applied.

RESULTS

Eighty-nine per cent of HCWs believed that they were at risk of acquiring HIV through occupational exposure. The perception of professional risk was higher among HCWs frequently exposed to patients' blood and body fluids (OR 7.9, 95% CI 4.4-14.5), who used additional personal protection if the HIV status of patient was known (OR 2.6, 95% CI 1.5-4.6), who had experienced sharp injuries within the last year (OR 1.9, 95% CI 1.0-3.8) or who had been tested for HIV (OR 2.1, 95% CI 1.2-3.5), and among HCWs who had treated HIV-positive patients (OR 1.7, 95% CI 1.1-2.8). The majority of respondents had deficient knowledge about modes of HIV transmission. Attitudes towards HIV-positive patients were significantly different by occupation. Seventy per cent of HCWs used appropriate protection during their daily work with patients.

CONCLUSIONS

HCWs require specific educational programmes and training protocols to ensure that they are adequately protected when carrying out high quality care.

Willingness of dentists in Jordan to treat HIV-infected patients

Reluctance of dentists to treat human immunodeficiency virus (HIV) positive patients represents a major concern. Many efforts have been extended towards the documentation of the extent of this reluctance and speculation of factors that influence it.

OBJECTIVES

Assess the willingness of dentists in Jordan to treat HIV-infected patients.

MATERIALS AND METHODS

Two hundred and forty-two general dental practices were surveyed for their willingness to provide treatment of toothache and routine dental care of an HIV-infected individual.

RESULTS

Only 15% of the dental practices were willing to provide such care. Willingness to provide treatment did not seem to be influenced by financial factors or the local prevalence of HIV disease.

CONCLUSION

Present data suggest that HIV-infected individuals will have difficulty in obtaining dental health care in Jordan.

Knowledge, Attitude and Practice Towards Droplet and Airborne Isolation Precautions Among Dental Health Care Professionals in Shiraz, Iran

OBJECTIVE

To determine the level of knowledge, attitude and practice among Iranian dental health care professionals towards droplet and airborne isolation precautions, in Shiraz, Iran.

METHODS

A survey was developed and distributed to 152 Iranian dental professionals (faculty and students) from Shiraz University School of Medical Sciences, School of Dentistry, Shiraz, Iran. The self-administered questionnaire was composed of three parts (knowledge, attitude, and practice). After validation of the survey using the Kuder Richardson reliability test and Cronbach's alpha internal consistency coefficient, data was collected and analyzed using Analysis of Variance and the Duncan test to detect the differences among groups. The Spearman coefficient was used to determine the correlation between knowledge, attitude, and practice.

RESULTS

The survey was completed by 152 (51.5%) of 295 potential respondents. Mean scores of knowledge, attitude, and practice towards droplets and airborne isolation precautions were poor (98 +/- 3.45, 10.51 +/- 6.26, 2.68 +/- 3.16 from the maximum scores of 11, 55, and 11, respectively). In addition, a positive linear correlation was found between two items of the survey including knowledge-attitude (rho = 0.438, p < 0.001), knowledge and practice (rho = 0.380, p < 0.001).

CONCLUSION

Iranian dental professionals seemed to have low levels of knowledge, attitude and practice towards infection control.

Evaluating infection control practices among dentists in Vâlcea, Romania, in 1998

OBJECTIVES

To evaluate infection control knowledge and practices, provide training on universal-standard precautions (USP), and improve infection control knowledge and practices among dentists.

SETTING

Private and public dental offices in Vâlcea, Romania.

METHODS

Information about the use of hepatitis B vaccine, knowledge of and training in USP, perceived risks of disease transmission, and infection control practices was gathered from a sample of dentists through interviews, direct observations, and a survey administered during a training session.

RESULTS

Interviews among dentists and direct observations of infection control practices revealed that resources were often scarce in public clinics; however, availability of supplies in private or public clinics often did not correlate with adherence to proper infection control. Of 125 registered dentists, 46 (37%) attended the session and completed the survey. Of these, 75% worked in public clinics, 40% in private practices, and a few in both. More than 50% believed that the prevalence of hepatitis B virus (HBV) was low in their patients compared with the Romanian population. Only 26% of dentists had received hepatitis B vaccine. Dentists reported a mean of six percutaneous injuries a year. Most (89%) reported that gloves were effective in preventing HBV transmission; 24% wore them for every patient. Most used dry heat sterilization; however, chemical disinfectants were also used.

CONCLUSIONS

Resources were limited, receipt of hepatitis vaccine was low, and infection control knowledge and practices varied. Training and education are needed regarding the importance of USP, hepatitis B vaccination, and alternative practices when resources are insufficient.

Assessment of the compliance of Nigerian dentists with infection control: a preliminary study

OBJECTIVE

To assess the compliance of a group of Nigerian dentists with standard infection control practices.

METHOD

A confidential self-administered questionnaire survey was conducted among dentists engaged in active clinical practices in public hospitals in Lagos, Nigeria (n = 185).

RESULTS

One hundred forty-six questionnaires were returned (response rate, 78.9%). Most (70.6%) of the dentists always wore gloves when treating patients, whereas 29.4% sometimes did. Regarding facemasks, 45.9% always wore them, 52.7% sometimes wore them, and 1.4% never wore them. Protective eye wear was always worn by 4.8% of the dentists, sometimes worn by 52.7%, and never worn by 42.5%. Approximately half (50.7%) of the respondents had received hepatitis B vaccination. Sterilization was performed using a combination of methods, including autoclaving (84.1%), boiling (19.3%), dry heat (17.5%), and chemicals (29.7%). Nonavailability of materials was the major reason for noncompliance with infection control practices.

CONCLUSIONS

Nigerian dentists need continuous education regarding infection control. Also, Nigerian hospitals urgently need adequate funding for up-to-date and functional equipment and materials.

[Evaluation of the dental students' knowledge on HIV infection. Analysis before and after an informative lecture]

The knowledge about HIV infection and AIDS is essential to the dentist. So they should be prepared in the use of measures of cross infection control. The purpose of this research is to evaluate the general and specific knowledge about HIV infection, of the dental students before and after an informative lecture on the subject. In the first stage of the evaluation 160 questionnaires, were given to the students. In the second stage, 3 months later, they went to a 15 minutes lecture about the HIV infection, afterwards another 160 questionnaires were given to the same students. In the questionnaires filled before the lecture the total success index was of 49% and of mistakes was 45.9%. After the lecture those values were 54.4% and 40.8% respectively. We concluded that even after the informative lecture the students presented a high mistake index and little assimilation of the subject, indicating that just 15 minutes of lecture was insufficient for a subject of great importance. The graduation dental students need more information on the HIV infection as well as up to date informative aspects.

[Hepatitis B vaccination among dentists surgeons]

OBJECTIVE

Serological studies in several countries have found a higher prevalence of hepatitis B virus (HBV) among dentists when compared to the general population, especially among surgical specialties. The present study was carried out to determine the prevalence of hepatitis B (HB) vaccination and factors associated with no vaccination and incomplete vaccination among dentists.

METHODS

A survey was conducted among 299 dentists living in Montes Claros, southeast Brazil, using a self-administered questionnaire. HBV vaccination prevalence was determined according to the number of doses of vaccine and factors associated with no vaccination or incomplete HBV vaccination were investigated using multinomial logistic regression analysis.

RESULTS

Participation rate in the study was very high (296/299). Of the participants, 74.9% received three doses of HBV vaccine, 14% two doses, 2% a single dosis and 10% were not vaccinated. Complete vaccination rate was higher among surgeons and periodontists (89%). The main reason reported for not being vaccinated or incomplete vaccination was the need of more information. No vaccination was significantly higher among dentists aged 40 years and over (OR=8.62; 95%CI: 1.88-39.41) and those who did not attend refreshment courses in the last two years prior to the survey (OR=2.72; 95%CI: 1.02-7.22). Incomplete vaccination was positively associated with non-use of gloves during work (OR=2.32; 95%CI: 1.08-4.97).

CONCLUSIONS

Lack of information, possibly associated to lower attendance to refreshment courses, seems to be one of the main factors affecting the vaccination rate.

Attitudes of a group of Mexico City residents toward HIV/AIDS in the dental office

OBJECTIVE

To ascertain the intention of the public to undergo dental treatment at dental clinics where other patients or a dentist are infected with HIV/AIDS.

STUDY DESIGN

A cross-sectional design was used to interview a stratified sample of persons 18 years and older in Mexico City with use of a standardized questionnaire. Questions included the type of dental service used, the perception of risk for HIV/AIDS contagion in the dental environment, and the reported intention to continue treatment in a dental office where patients or a dentist were affected by HIV/AIDS.

RESULTS

Of the 490 participants, 74.9% were concerned about HIV/AIDS transmission in the dental office. Only 21.2% intended to continue treatment at a dental office where HIV/AIDS patients were treated, and only 20.0% intended to continue treatment when the dentist was HIV-positive. The degree of concern about HIV/AIDS contagion and the modality of dental service used were associated with the stated intention to continue dental treatment.

CONCLUSIONS

There is a need to have good infection control standards in dental practice; to increase public trust in such standards by making them more apparent; and/or to establish educational programs to improve public knowledge and attitudes toward HIV/AIDS risks in dental practice.

Biologic monitoring of dental office sterilizers in Mexico

BACKGROUND

Biologic indicators (BIs) are the quality control applicable to sterilization cycles, but their use was not previously taught in Mexican dental schools or recommended by professional associations. A Mexican official standard, the Mexican Official Norm, published by health authorities in 1999 makes it compulsory for dentists to biologically verify sterilization cycles. However, only a few dentists comply because the use of BIs is largely unknown and the standard is not being enforced.

OBJECTIVE

To evaluate the incidence of sterilization failures in a convenience sample of dental offices in Mexico.

METHODS

Spore strips were distributed to dentists interested in using this service. The dentists mailed the processed BIs to the laboratory for culture.

RESULTS

In 6 years, 3277 tests were submitted from 82 dental offices. Thirty-four offices (41%) submitted 1 to 12 tests, 22 (27%) sent 14 to 48 tests, 18 (22%) mailed 49 to 96 tests, and 8 (10%) sent >97 tests. The sterilization methods were steam (74.4%), dry heat (20%), and chemical vapor (5.6%). A total of 242 sterilization failures (7.4% of all cycles) were detected. Convection dry heat failed with a greater frequency with chi(2) analysis (chi(2) = 13.71, P =.0175).

CONCLUSIONS

Sterilization failures occurred in instrument loads used in patient treatment. Steam and chemical vapor under pressure failed less often than convection dry heat. When corrective action is taken, routine use of BIs increases patient safety.

Attitudes toward HIV-infected individuals and infection control practices among a group of dentists in Mexico City--a 1999 update of the 1992 survey

BACKGROUND

The teaching of infection control (IC) was introduced at dental schools in Mexico during the 1990s. A 1992 survey indicated that some dentists had limited access to current IC standards. Deficient knowledge of bloodborne pathogens may influence dentists' attitudes about infected individuals and reduce compliance with IC recommendations.

OBJECTIVE

To update the 1992 appraisal of attitudes about persons infected with HIV or the hepatitis B virus (HBV) and IC knowledge and practices in a nonrepresentative sample of dentists in Mexico City.

METHOD

One hundred eighty dentists were interviewed in 1999 (response rate, 84.1%) with the same methods used in 1992.

RESULTS

Seventy-nine percent of respondents perceived the risk of HIV infection as "considerable" to "very strong." The risk of HBV infection was considered higher than that of HIV. Only 32% of respondents had not been immunized against HBV. Reported use of personal protective equipment remained high. Dry heat was the preferred method for sterilization in 1992, but by 1999 it had been displaced by steam under pressure. Reported preference for more effective disinfectants was also evident overall.

CONCLUSIONS

We found certain improvements in IC knowledge and practices between 1992 and 1999, and the results suggest targets for educational and regulatory efforts that are needed to promote better adherence to current IC standards.