1) Healthcare workers such as doctors, nurses, and paramedics are at risk of contracting HIV through needle pricks and exposure to bodily fluids of infected patients. 2) The virus can enter the body through cuts, wounds, or needle pricks while handling infected individuals without protection. Over 350,000 needlestick injuries occur among healthcare workers each year. 3) If a healthcare worker experiences a needlestick injury or other exposure, first aid should be provided and the worker tested and counseled. Post-exposure prophylaxis drugs may be given for 28 days to prevent infection depending on the risk level.

1. AIDS
PREVENTION
Mini Sood

2. Occupational risks
Who gets
injured?
Doctors,
nurses
Surgeons
Obstetricians Anesthetists
Paramedics
handling soiled
products

3. Transmission
•How and why, they get injured
• The infection occurs through the virus getting injected through
cuts, wounds, needle pricks and any other breaks in the skin
surfaces, while handling HIV positive individuals, without
protection.
• Through needle pricks amongst drug users.
• During a blood transfusion.
• During pregnancy from mother to baby(MTCT)

4. Occupational risks
How often do
they get
injured?
Needle stick
injury- 1 in
10,000
350,000 Injuries
per year- 1000
sharps per day
Cuts- Wounds Abrasions

5. RATIO OFTHETYPES OF
SHARPS AND INJURIES

6. THE SHARP ANDTHE EVENT
AND INFECTION

7. Needle stick injuries-When and
how- with methods to prevent
Load or
reposition
Load or
reposition the
needle into the
needle holder
Pass
Pass the needle
hand-to-hand
between team
members
Sew
Sew toward the
surgeon or
assistant while
the surgeon or
assistant holds
back other
tissue
Tie
Tie the tissue
with the needle
still is attached
Leave
Leave the
needle on the
operative field
Place
Place needles
in an over-filled
sharps
container
Place
Place needles
in a poorly
located sharps
container

8. Risks and transmission
Other non -sexual modes of exposure to
the contaminated blood
Handling soiled linen, tissues, body fluids
like urine, stool, blood, vomitus, liquor
amnii without the protection of gloves.

9. Background statistics
•Costs of Injuries and Exposures

10. Prevention of
infection
Infection control policies in theatre
areas
Cleaning
Disinfectants
Autoclaving instruments
Fumigation

11. Testing of an
exposed Health
care worker
• First Aid
• Counseling
• Assessment of risk
• HCW testing and recording
• Testing should be immediate and based on the
hospital policy.
• Starting anti-retroviral drugs- for an initial 28
days following consultation with an HIV
specialist
• Appropriate support and follow up.
• Repeat testing at 6 weeks, 3 months, and 6
months for the seroconversion
• Advice to follow safe sex if with a partner and
provide a psychological support to reduce
stress.

12. Counseling
• Discuss the risks of transmission
• Discuss antiretroviral therapy
• Discuss window period – immediate test with
follow up tests at 6 weeks, three months, and
six months.
• Safety during the window period
• A) avoid donation – blood/semen/organ
• B) Avoid breastfeeding pregnancy
• C) Do not share needles
• D) Use a condom
• E) Inform your sexual partner

13. Post exposure
prophylaxsis not
needed when
• When the exposed individual is already HIV+
• If there is a chronic exposure (sex worker not
using protection)
• If the exposure does not carry a risk
• If the exposure occurred more than 72 hours
prior

14. 1. zidovudine 300
mgs twice daily
+lamivudine 300
mgs once daily
2. zidovudine +
emtrictabine
200mgs
3.Tinofir df 300mgs
once+lamivudine
4. tenofovir
+emtrictabine
TREATMENT REGIMENS
AFTER POSTEXPOSURE
PROPHYLAXSIS
BASIC HIV PEP REGIMENS-
FOR 28 DAYS

15. Expanded
regimen
• Basic regimen plus Lopinavir 300mgs/day and
Ritonavir 75mgs/day or Ritonavir 100mgs
twice daily
• Alternate Expanded regimens
• Basic regimen plus one of the plan given below
• A) Atazanavir 400mgs once daily ritonavir
• B) Fosamprenavir 1400mgs twice daily
• C) Indinavir 800mgs +ritonavir
• D) Saquinavir 1000mgs +ritonavir
• E) Nelfinavir 1250mgs twice daily
• F) Efavirenz 600mgs daily.
• (Regimens modified to guidelines and drugs
available)

16. in current times
the hiv positive
hcw can live and
lead a normal life
after taking the
haart therapy
EMPLOYMENT AFTER
HIV POSITIVE STATUS

17. a) allow the HCW to
continue work with
no reservations
b) stop current
activities
c) counsel and
monitor the HCW
while exercising
judgement over
allowing work
OPTIONS FORTHE HCW
ONCETESTED POSITIVE

18. Beliefs
• The patients’ rights come first
• Not wise to hide the HCW status
• Non-disclosure of the HCW ‘s HIV status is
justified only if the public does not expect the
disclosure’
• Better to train the public not to want a
disclosure
• The HCW must always be protected – the
hospital should discreetly allow them to work
when on the treatment
• To maintain the non-discriminatory
environment, towards the HIV + patients, we
need to feel nondiscriminatory towards both
the patients and the infected HCW’s

19. THANK
YOU