Srinivas Kuruganti, Freedom Foundation, Bangalore India
Prevention of transmission in health care settings:
Blood Transfusion Safety22
• Screen all donated blood for HIV, syphilis, hepatitis B and C viruses.
• Identify donors who are at low risk of HIV infection.
• Universal precautions consist of: safe handling and disposal of sharps, safe decontamination of instruments, hand washing after all procedures, use of protective barriers to prevent direct contact with blood and body fluids, safe disposal of contaminated waste.
• Ensure adequate supplies and training of health workers in universal infection control precautions, including the safe handling of needles, sharps and medical waste.
Post-exposure Prophylaxis for Occupational Exposure to HIV
• Develop a protocol and provide training to staff to address occupational exposure to HIV, including information on post-exposure prophylaxis (PEP). Post-exposure prophylaxis means prevention after exposure, for example after a needle stick injury. A combination of antiretroviral drugs is used. The United States Public Health Service has established guidelines for the management of occupational exposures to HIV.23 The UN and Medecins Sans Frontieres also have guidelines on PEP.
Post-exposure Prophylaxis for Non-occupational Exposure to HIV
• Explore the availability and use of PEP for preventing transmission of HIV after rape. Although the research on the efficacy of PEP after rape is inconclusive, it is used in some settings.24,25
• If the service is available, develop a list of provider names and addresses for referrals.