HIV Preventative Measures Health Article

Occupational HIV transmission

Although it is not a primary means of transmitting the spread of HIV, there are documented cases of HIV seroconversion among health workers. Responsibility for preventing occupational exposure to HIV and other bloodborne pathogens is that of the nurse. Precautions include the routine use of gloves for one-time use, goggles, and disposable protective clothing. These function as preventive barriers when there is the possibility of coming in contact with infectious materials. Good hand-washing practices are essential. It is necessary that sharp instruments and contaminated materials are handled and disposed of in a proper manner.

Prevention

Sustained, comprehensive efforts of the 1980s have had a significant impact on slowing the spread of HIV/AIDS in the United States. Although it is difficult to determine exactly how many thousands of infections were prevented as a result of deliberate effort, the mid-1980s witnessed an epidemic growing at an annual rate greater than 80%. As of mid-2001, this rate has stabilized. Nationally, 30 of every 100,000 men and nine of every 100,000 women have AIDS. Despite the occurrence of 40,000 new cases per year, fewer people are dying from AIDS and AIDS-related complications. This is indicative of tremendous progress. In general, previous preventive efforts resulted in many behavioral changes, thereby helping to slow the epidemic overall.

The decline in the number of deaths from AIDS and the effectiveness of antiretroviral therapies increase the number of HIV infected people in the general population. These successes may contribute to a person's false sense of security when he or she believes and behaves as if preventing the spread of HIV is no longer important. Complacency about the need for prevention adds a complex dimension to disease management for health care professionals and the at-risk population. The complicated nature of HIV/AIDS strongly supports valuable opportunities for prevention and intervention.

Primary HIV prevention means keeping people from becoming infected with HIV in the first place. Intervention must focus on preventing the spread of HIV by infected individuals as well as on acquisition by uninfected populations. Infected individuals need to develop skills to reduce the risk of infecting others. It is essential that there be easy access to voluntary blood testing; this will enable early detection of HIV infection.

Comprehensive school-based HIV and sex education programs are suspected to delay initiation of sexual activity in teenagers, reduce the frequency of intercourse for those who are sexually active, decrease the number of sexual partners they have, and increase the use of condoms and other contraceptives.

Stringent screening of donor blood supply for HIV antibodies, and heat-treating blood products used to treat hemophilia have nearly eliminated HIV transmission through transfusions.

Secondary HIV prevention is keeping HIV-infected people safe and healthy by helping them avoid opportunistic infections and stopping the infection from progressing to AIDS.

Scientists are exploring the possibility that combination drug therapies may reduce the infectious nature of the disease. With the lines between prevention and treatment beginning to merge, ongoing services for people who are HIV positive must balance medical advances with the behavioral and social support needed to preserve their quality of life and prevent the spread of infection.

A focus on behavioral change is paramount. Vaccines are not able to prevent disease if people are not vaccinated. No vaccine for lifelong immunity has yet been developed. Further, medical advances are unsuccessful unless their implementation parallels that of effective prevention strategies. People must be receptive to both in order for HIV rates to be reduced.

Pregnant women who may not know they are infected with HIV cannot reduce the risk of transmitting the disease to their unborn children unless that they get prenatal care, routine HIV counseling, and submit to voluntary testing. Infected patients must have access to anti-retroviral drugs. Programs that identify and treat HIV-infected pregnant women have shown dramatic success in reducing HIV transmission to their babies. A woman who is HIV-positive and pregnant may be advised by her doctor to deliver by cesarean section (cs) to eliminate the chance of transmitting the virus during childbirth.

Efforts to reduce the risk for HIV infection of injection drug users through public attitudes and policies have been very effective. State health departments have reported significant reductions in the sharing of drug injection equipment after implementing programs to increase access to sterile injection equipment.

Infected individuals need assistance developing skills to use the new medical treatments. Highly active antiretroviral therapy (HAART) involves complex treatment regimens and requires compliance-related skills. Patients need to learn how to deal with the side effects of medications and drug interactions. They must learn how to decrease the risk of developing drug resistance by taking their medications as recommended and also learn how to work with complicated medication schedules. HIV-positive individuals also depend on the support of family and friends to continue their drug regimens and to encourage prevention of transmission to others.