title: Antiretroviral prophylaxis of health care workers at two urban medical centers.
abstract: We examined the influence of job category, source patient HIV status, and exposure type as predictors of whether health care workers initiated antiretroviral prophylaxis after potential blood-borne pathogen exposures. Of 639 exposures over an 18-month period, 82 individuals (13%) elected to receive prophylaxis, of whom 66% took medications for fewer than 96 hours and 12% completed a 4-week course. Reasons for early drug discontinuation included confirmation of source patient HIV-negative serological status (65%), gastrointestinal side effects (13%), headache (4%), and personal decision after counseling/other input (18%). Individuals exposed to HIV-positive source patients were more likely to initiate prophylaxis (odds ratio [OR], 5.1; 95% confidence interval [CI] 2.6 to 9.9). Licensed nurses were less likely than others to accept prophylaxis (OR, 0.5; 95% CI, 0.3 to 0.8), whereas physicians and medical students were more likely to accept prophylaxis (OR, 1.9; 95% CI, 1.1 to 3.3).
authors.affiliation: Occupational and Environmental Medicine Program, Yale University School of Medicine, New Haven, CT 06504, USA.
authors.forename: M
authors.initials: M
authors.lastname: Russi
authors.forename: M
authors.initials: M
authors.lastname: Buitrago
authors.forename: J
authors.initials: J
authors.lastname: Goulet
authors.forename: D
authors.initials: D
authors.lastname: Calello
authors.forename: J
authors.initials: J
authors.lastname: Perlotto
authors.forename: D
authors.initials: D
authors.lastname: van Rhijn
authors.forename: E
authors.initials: E
authors.lastname: Nash
authors.forename: G
authors.initials: G
authors.lastname: Friedland
authors.forename: W
authors.initials: W
authors.lastname: Hierholzer
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage*; D017848:Blood-Borne Pathogens; D016009:Chi-Square Distribution; D005260:Female; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission; D006282:Health Personnel / Q000523:psychology; D006509:Hepatitis B / Q000517:prevention & control* / Q000635:transmission; D006526:Hepatitis C / Q000517:prevention & control* / Q000635:transmission; D006786:Hospitals, Urban; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016602:Needlestick Injuries; D016273:Occupational Exposure; D010342:Patient Acceptance of Health Care
chemical_list: D019380:Anti-HIV Agents