Effectiveness of and compliance to preventive measures against the occupational transmission of human immunodeficiency virus.
To prevent the occupational transmission of human immunodeficiency virus (HIV) and other blood-borne infections in health care settings, guidelines have been issued as universal precautions and body substance isolation. Patient testing has also been advocated. The literature on the compliance to and effectiveness of these measures was reviewed and analyzed to establish the state of knowledge and make appropriate recommendations to improve guidelines. It showed that workers' compliance to recommended measures is relatively poor. The effectiveness and cost-effectiveness of universal precautions and body substance isolation remain to be demonstrated. Testing patients for HIV infection and other bloodborne pathogens does not appear to be a more appropriate solution. Focus should be placed on preventing parenteral exposures and applying risk assessment methods to identify health care settings and procedures at higher risk. These measures would allow safer medical devices to be targeted and would ensure that financial resources would be available to implement appropriate preventive measures.
Roy
E
E
Centre for AIDS Studies, Montreal General Hospital, Canada.
Robillard
P
P
D017408:Guidelines as Topic; D015658:HIV Infections / Q000191:economics / Q000517:prevention & control* / Q000635:transmission; D006282:Health Personnel; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000191:economics / Q000517:prevention & control*; D008403:Mass Screening; D016273:Occupational Exposure / Q000191:economics / Q000517:prevention & control*; D018570:Risk Assessment; D016635:Universal Precautions / Q000191:economics