Exposure to HIV: medical management and legal implications.
The management of exposures to HIV, whether occurring in the occupational or non-occupational setting, involves balancing the risk and inconvenience of antiviral therapy that lacks strong evidence of efficacy against the benefit of it possibly preventing a potentially fatal disease. Clinicians increasingly will be responsible for managing Health Care Workers (HCWs) and other persons exposed to HIV. This will require making a clinical assessment of the risk of HIV transmission and making recommendations for postexposure prophylaxis (PEP) according to the CDC, and other guidelines. Management also requires applying the elements of the doctrine of informed consent, considering involuntary testing of source patients, and reporting of exposure incidents. Proper management will protect all those involved: the exposed person will be protected from unacceptable risks either of contracting HIV, should PEP be indicated, or harm caused by PEP when it is not; the source patient will be protected from unconstitutional invasions of privacy. Finally, the clinician will be protected from claims of malpractice as a result of management of an HIV exposure.
Greenwood
M J
MJ
Aero Med at Spectrum Health, Grand Rapids, Michigan, USA.
D000488:Allied Health Personnel; D003376:Counseling; D004636:Emergency Service, Hospital; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission; D006801:Humans; D018580:Mandatory Testing; D016273:Occupational Exposure; D017410:Practice Guidelines as Topic; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use; D018570:Risk Assessment; D015215:Zidovudine / Q000627:therapeutic use
D018894:Reverse Transcriptase Inhibitors; D015215:Zidovudine