Management of HIV/AIDS
Pg 2


Percent Risk Behavior of US men in 1996  source:CDCPercent Risk Behavior of US women in 1996 source:CDC
As of December 2001, 44% of US men with AIDS contracted the virus by having sex with men, while the majority of US women (41%) contracted HIV through heterosexual contact. Thirty-nine percent of women contracted HIV via injecting drug use. The impact of AIDS on minorities has been felt. Blacks represent the majority of cases as of 2001. 1
AIDS in Blacks and Hispanics

Of the 816,149 AIDS cases in US residents reported to CDC through 2001, Blacks and Hispanics accounted for:

  • 80% of total
  • 61% of women
  • 83% of heterosexuals*
  • 82% of children

In one year (1996) Blacks and Hispanics accounted for 61% of AIDS cases reported.

*Heterosexual injecting drug users and persons with heterosexually acquired HIV

Source: CDC

Persons at High Risk of Contracting HIV Infection

  • Injection drug user (IDUs)
  • Gay and bisexual men
  • Recipients (including hemophiliacs) of blood products who received product between 1978 and 1985 (before screening)
  • Heterosexual contacts of any of the above
  • Newborns of HIV-seropositive mothers
  • Persons who have contracted other sexually transmitted diseases
In view of these statistics, it is clear of whom is at high risk for contracting HIV, and efforts toward screening and prevention education can be targeted accordingly. These risk groups have not changed since the advent of the epidemic and include injecting drug users, gay and bisexual men, blood product recipients (especially between 1978 and 1985), hemophiliacs, sexual contacts of these groups, and newborns of HIV-seropositive mothers.
As the years progress, the number of cases involving receipt of blood products should continue to shrink. Blood has been screened for HIV since 1985, and it can therefore be assumed that virtually all cases of AIDS obtained in this manner likely would have been detected by now, especially since virus exposure in this form is much greater than via percutaneous spread or sex.9 It is still possible to contract HIV via blood, particularly in other countries where screening processes are under significantly less scrutiny. In this country, between careful history-taking and serological screening for other sexually transmitted diseases, as well as p24 antigen, the risk is down to approximately one in 500,000 units.10 Risk remains because of the conversion window period and the fact that, with the exception of p24, HIV antigens are not screened. To do so would be cost intensive and at this time would raise the price of a unit of blood to prohibitive levels.
Persons at little or no risk for HIV infection include household contacts, casual contacts and health care workers. While HIV transmission to hemophiliac siblings has been reported, these cases represent unusual or atypical circumstances.

Persons at Little or No Risk
of Contracting HIV Infection

  • Household contact
  • Casual contacts
  • Health care workers

Risk of HIV Transmission
Among Health Care Workers

Risk of HIV infection from
needle-stick =0.36% or 1 in 250 exposures

  • >57 occupationally derived
    seroconversions documented;

HOWEVER,

  • >33% might have been prevented with consistent use of Standard Precautions
The occupational risk among health care workers does not exceed that of the general population. The risk of infection following a needlestick from a documented HIV infected source is 0.36%, or one in 250 exposures. This has remained consistent over the years through ongoing studies conducted by the CDC.11 Of course, the risk is much less when serological status of the source is not known. To date, there have been 57 documented seroconversions acquired occupationally, and 137 possible occupational seroconversions1 More than a third of these seroconversions could have been prevented through proper observation of universal precautions/body substance isolation.

 

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