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Avatar universal

HIV Transmission in Healthcare vs Public, What's the difference?

From my previous post below "HIV Exposure Worth Getting Tested For", I have more questions regarding accidental HIV blood transmission in the general public, and why it doesn't lead to infection.

I keep seeing websites that discuss healthcare workers being "exposed" when they come into mucous membrane or broken skin contact with blood from an HIV source on the job. Why is that different than if I were to shake somebody's hand, they have blood on their hand, and it gets into a cut on my finger? And for instance in sports, why is HIV not being spread in sports like football and basketball? I have had someone else's blood on me several times when playing either of these. What makes blood contact in hospitals worse and why are there people that have been recorded as being infected in healthcare settings, but not in sports or casual contact where one person may be bleeding and the other has un-intact skin? (I have never heard of a case where HIV was transmitted in sports.) Does it have someting to do with the amount of virus in the blood that healthcare workers deal with?

(I thought this was a different question so I made a new topic)

5 Responses
239123 tn?1267651214
MEDICAL PROFESSIONAL
The situation in health care settings proves the point.  I'm just guessing, but I would bet that in the 25 years of dealing with millions of hosptializations and tens (hundreds?) of millions of outpatient medical visits by HIV infected people in the United States, and with at least many thousands of needle-sticks and other exposures to HIV infected blood and body fluids, fewer than 100 exposed health care providers have become infected with HIV.  For all I know, it might be fewer than 10.  (If a forum user wants to search this on the web or elsewhere and can find an estimate, I would be interested in seeing it.  And if my guesstimate is wrong, I will cheerfully admit it.)  In any case, HIV transmission to health care providers is an extremely rare event.

HHH, MD
Avatar universal
I think it is because 99.5 % of people don't have HIV in the general population so even if you swam in their blood you wouldn't get it.  Also, it needs to be iether mainlined like through a needle stick or from a large amount of blood like in the eyes. That and the fact that I think a higher percetage of people coming to ERs have HIV and often their blood is squiring everywhere. Combine that with the fact that people are working in that environment everyday. Only a handfull of healthcare worker have it.
Avatar universal
It's also hard to document these things because we don't know how many of the healthcare workers have also had unprotected sex. When an HIV case is documented, the CDC or public health people do an assessment of the person's risk history. So let's say a nurse has had a few needle-pricks and also sleeps with a guy she doesn't know well, who is promiscuous, without a condom. She turns up HIV positive. Unless the CDC has rock-hard information about both exposures, they have to guess about which exposure was responsible. So the guesswork then works its way into the statistical model and turns into circular logic. Most people who get infected have had multiple possible exposures so therefore their cause has to be attributed by guesswork.

Another example of circular logic: Many heterosexual black women turn up HIV positive after having sexual relations with black men who claim they have no homosexual relationships. What do health officials say to explain it? They begin with the model that states that female-male heterosexual transmission in the US is exceedingly rare, and then look for signs that some of the black men are closeted homosexuals. The more the black males insist they are not gay, the more the health officials then become convinced that they must be closeted. So then they conclude that black women get infected by men more often because the men with whom they sleep are also sleeping with men. This becomes part of the statistical model and then the beginning assumption--that heterosexual transmission is statistically rare--appears even more confirmed, even though the whole exercise was really circular logic and a self-fulfilling prophecy.

This is why I say the statistical formulae to figure out people's individual risk are truly pointless. On an epidemiological level they are important in preventive measures for an entire population. But on a case-by-case basis numbering people's odds is by its nature flawed. My final example would come from this forum: We have heard repeatedly that most women in the US do not have HIV, even sex workers, so therefore casual vaginal sex without a condom is unlikely to cause infection in a male. Yet last summer and fall I remember distinctly several different HIV-positive women who posted on this website, as well as one man whose wife was HIV-positive and who was trying to figure out the best way to prevent transmission. When you become too convinced of percentage points you may miss the obvious right in front of you.

The only answer to everyone's fear, unfortunately, is to use protection and when you haven't used protection, to get tested. Everything else is a mirage.

J
Avatar universal
Here is a document reporting more than the U.S.



http://www.hpa.org.uk/infections/topics_az/hiv_and_sti/publications/hiv_octr_1999.pdf
Avatar universal
The most recent information I have found so far regarding HIV transmission in Healthcare Workers is as follows:

I can't guarantee the reliability of it but it was found at
http://www.avert.org/needlestick.htm

How many occupational infections have been reported?

Up until December 2001, health care workers in the USA reported 57 occupational HIV infections. Of these, 48 had percutaneous exposure; 5, mucocutaneous exposure; 2, both percutaneous and mucocutaneous exposure; and 2, an unknown route of exposure. In addition, 139 other cases of HIV infection or AIDS have occurred among healthcare personnel who have not reported other risk factors for HIV infection and who report a history of occupational exposure to blood, body fluids, or HIV-infected laboratory material, but for whom seroconversion after exposure was not documented.

Occupation & Documented Occupational Transmission

Dental worker including dentist 0
Embalmer/morgue technician 1
Emergency medical technician/paramedic 0
Health aide/attendant 1
Housekeeper/maintenance worker 2
Laboratory worker, clinical 16
Laboratory technician, nonclinical 3
Nurse 24
Physician, nonsurgical 6
Physician, surgical 0
Respiratory therapist 1
Technician, dialysis 1
Technician, surgical 2
Technician/therapist, other than listed 0
Other health care occupations 0
Total 57

The Department of Health and Human Services
Centers for Disease Control and Prevention also states the above numbers and advises that there are no new updates since 2001.
That information can be found at
http://www.cdc.gov/ncidod/dhqp/bp_hiv_hp_with.html

and they also said the following abut it all:-

Of the adults reported with AIDS in the United States through December 31, 2002, 24,844 had a history of employment in healthcare . These cases represented 5.1% of the 486,826 AIDS cases reported to CDC for whom occupational information was known (information on employment was missing for 362,954 reported AIDS cases).

The type of job is known for 23,212 (93%) of the 24,844 reported healthcare personnel with AIDS.
The
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