Is it acceptable for a physician to break confidentiality in the case of sexually transmitted diseases? A mapping of young Kuwaiti's views

IntroductionConfidentiality is essential for the establishment of trust between physicians and their patients.ObjectivesThe circumstances under which it is acceptable to young Kuwaiti for a physician to break confidentiality to protect the spouse of a patient with a sexually transmitted disease (STD) were examined.MethodA sample of 263 young Kuwaiti indicated the acceptability of breaking confidentiality in 48 scenarios that were all possible combinations of five factors: disease severity, time taken by the physician to discuss with the patient, the patient's intent to inform the spouse about the disease, the patient's intent to adopt protective behaviors, and the decision to seek the advice of an expert in infectious diseases before breaking confidentiality.ResultsThrough cluster analysis, four qualitatively different positions were found: Quite never acceptable (6% of the sample, mostly males), Depends on husband's willingness to inform (3%), Depends on husband's protective behavior (29%, mostly females), and Quite always acceptable (32%). The remaining participants did not express any clear view.ConclusionIn Kuwait, students’ trust in the medical profession is, therefore, not likely to be seriously undermined if, from time to time, and in well-specified cases, individual physicians decide to break confidentiality when facing dilemmas of the kind examined in the current study.     

Body image and risky sexual behaviors: an investigation in a tri-ethnic sample

The impact of negative body image on risky sexual behaviors has not been extensively investigated. The present study examined the relationship between two aspects of body image, appearance shame and appearance investment, and potentially risky behaviors. The study employed a tri-ethnic sample of 1547 women seeking services at two family planning clinics. Logistic regression was utilized to examine the relationship between potential risk behaviors and shame and investment. Results supported that these aspects of body image were significant predictors of inconsistent condom use, having multiple sex partners in the past year, and having sex after drinking alcohol or using drugs, and that demographic variables (e.g., age, marital status, ethnicity) could not fully account for these relationships. The importance of future research investigating the relationships among body image, perceived relationship security, affect-management strategies, and risky sexual behaviors is emphasized.     

Associations of a Sexually Transmitted Disease Diagnosis During a Relationship with Condom Use and Psychosocial Outcomes: (Short) Windows of Opportunity

Few studies have examined whether and how receiving an sexually transmitted disease (STD) diagnosis while in a romantic relationship relates to condom use and psychosocial sexual outcomes. Using dyadic data, we examined associations of a personal or a partner’s STD diagnosis during a relationship with condom use, monogamy intentions, condom intentions and attitudes, and STD susceptibility and communication. Because beliefs about how the STD was acquired may shape associations with behavior and cognitions, gender and suspecting that one’s partner had other sexual partners (i.e., partner concurrency) were examined as moderators. Participants were 592 individuals in 296 couples expecting a baby; 108 individuals had been diagnosed with an STD during the relationship. Personal STD diagnosis was unrelated to outcomes or was associated with increased risk. A partner’s diagnosis related to more positive condom intentions and attitudes. Among men who suspected concurrency, both a personal and a partner’s STD diagnosis were associated with less condom use. Receiving the STD diagnosis during pregnancy was associated with greater susceptibility and marginally greater condom use. Results suggest potential benefits of enhancing communication and encouraging joint risk reduction counseling among couples, engaging men more fully in preventive efforts, and capitalizing on the short window during which risk reduction occurs.     

Topic-relevant cognition and empathic accuracy in laboratory discussions of safer sex

Abstract

The present study sought to identify some of the mechanisms that make safer sex such a difficult topic to talk about. Fifty six dating couples participated in a laboratory study in which the opposite-sex members of two pairs of couples engaged in two discussions of safer sex (or a control topic), each time with a different opposite-sex partner (their own dating partner or an opposite-sex stranger). The results indicated that discussions of safer sex evoke in dating partners a high level of perceived goal-incompatibility, difficulty maintaining one's focus on the topic, and difficulty in reading the other partner's thoughts and feelings. These reactions did not occur in response to the control topic. This initial demonstration study is important with respect to the processes it implicates, but further clarification is needed regarding the specific real-life conditions in which these processes do, and do not, occur.     

The role of STI-related attitudes on screening attendance in young adults

This study assessed whether attitudes towards STI screening, visiting a clinic and having an STI (STI stigma) predict STI screening attendance in young adults. Participants (N = 217) rated each of these attitudes and completed measures assessing their STI knowledge, past sexual behaviour and sexual health. STI stigma and having favourable attitudes towards STI screening positively predicted screening attendance. People were less likely to attend if they had a negative attitude towards visiting sexual health clinics. Researchers should assess attitudes towards the attitude object (screening), condition (STI stigma) and process (visiting a clinic) to understand the different ways that attitudes predict behaviour.     

Psychological factors in hiv testing among sexually transmitted disease clinic patients: An exploratory study

Abstract

Substantial numbers of persons at risk for HIV infection do not seek HIV testing and factors influencing testing decisions are not well understood. To identify psychological characteristics of persons who remain unwilling to receive HIV testing, we surveyed patients of an inner-city sexually transmitted disease (STD) clinic (n = 181). Participants completed an anonymous survey and were grouped on the basis of HIV testing history and compared on measures of testing perceptions, attitudes, and decision making influences. Results showed that untested participants feared testing and had a sense of not knowing if they needed to be tested. In contrast, participants who were getting tested believed that testing would help them feel better about their health. Results also showed that participants lacked accurate information about some HIV testing procedures. We conclude that identifying concerns which inhibit seeking HIV testing can be useful in developing effective methods of promoting HIV testing.     

反义技术抗病毒感染基因治疗的几点思考

众所周知,病毒感染对人类健康和社会经济均有严重影响,如ＡＩＤＳ,目前临床上尚无特效药物和疗法。随着分子生物学和生物技术的发展,提出反义技术抗病毒基因治疗———一种很有希望的治疗技术。这一技术是以病毒基因结构及其产物功能的辩证关系为基石,将随着病毒基因结构及其产物功能的辩证关系的深入研究而进一步完善     

Le risque médico-judiciaire des infections nosocomiales

These last years in France, the term ‘nosocomial infection’ has been replaced by ‘health-care associated infection’, which has a much broader definition. In all cases, the plausibility of the association between infection and the care provided deserved to be rigorously analyzed. To qualify an infection as nosocomial, the expert witness must at the judge's request determine that infection actually occurred within the health facility and is linked to health care. French Public Health Code as well the most recent jurisprudence give currently a rather close definition of nosocomial infection. The principle of faultness liability in the field of nosocomial infection has been enshrined in the law of March 4^th 2002, the most severe situations (death; permanent functional deficit > 25 percent) being compensated by ONIAM, the French national office of compensation for nosocomial infection.