Physicians' attitudes toward homosexuality and HIV: survey of a California Medical Society- revisited (PATHH-II).

In 1982, Mathews et al. surveyed San Diego County Medical Society's (SDCMS) physicians about their attitudes toward homosexuality. They found significant differences in prevalence of homophobic attitudes by gender, year of medical school graduation, specialty, and practice setting. To assess current physicians' attitudes toward homosexuality and persons with HIV infection, an anonymous, self-administered, 17-item survey was mailed to all 4,385 members of the SDCMS and 1,271 UCSD physicians. The survey included items measuring attitudes toward homosexuality and toward entry to medical school and referral patterns, conditional on sexual orientation and HIV status of hypothetical referents. Only 3% of respondents would not admit a highly qualified homosexual applicant to medical school compared with 30% in 1982. Similarly, 9% would discontinue referrals to a gay pediatrician compared with 46% of respondents in 1982. Forty-two percent would not admit a "highly qualified but asymptomatic HIV-infected applicant with excellent response to antiretroviral therapy to medical school" and 66% would discontinue referral to a general surgeon known to be HIV infected. In multiple logistic regression analyses controlling for sex and medical school affiliation, significant (p < 0.05) independent predictors of being in the highest 10% on an HIV-phobia scale were year of graduation from medical school and degree of homophobia (model ROC = 0.77). This survey suggests a substantial reduction in homophobia since 1982. However, attitudes toward homosexuals and year of graduation from medical school appear to be significant predictors of attitudes toward persons with HIV infection.