Pan-Thames survey of occupational exposure to HIV and the use of post-exposure prophylaxis in 71 NHS trusts.
OBJECTIVE
To review the management of occupational exposure to definite or suspected HIV-infected blood, following the introduction of the 1997 UK Department of Health guidelines on the use of post-exposure prophylaxis.


METHODS
Cross-sectional telephone survey of protocols in 71 NHS Trusts in the Pan-Thames region. Retrospective postal survey of the management of each definite or suspected HIV blood exposure between 1 July 1997 and 30 June 1999.


RESULTS
Sixty-two (93%) Trusts had a written protocol, with many specialties involved in exposure management. Twenty-four Trusts reported 171 occupational exposures to definite or suspected HIV-infected blood. Of 97 definite HIV exposures, eight (8%) were discovered on post-incident HIV testing of the source patient; to which most source patients agreed when approached. Seventy-two (74%) exposed health care workers started prophylaxis and 49 (68%) completed the recommended 4-week course. Only half of those whose exposures occurred more than 6 months ago were known to have had a follow-up HIV test.


CONCLUSIONS
Although most Trusts have implemented the Department of Health's guidance, collecting data on individual exposures proved difficult. We suggest that a designated department in each Trust co-ordinates and records HIV exposure management. Routine HIV testing is acceptable to most source patients and is appropriate in areas with a high prevalence of HIV seropositivity.
Grime
P R
PR
Department of Occupational Health & Safety, King's College Hospital, Denmark Hill, London, SE5 9RS, UK.
Ris
L
L
Binns
C
C
Carruthers
J R
JR
Williams
S
S
D017848:Blood-Borne Pathogens; D003430:Cross-Sectional Studies; D004739:England / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission; D006679:HIV Seropositivity; D015528:HIV Seroprevalence; D006282:Health Personnel; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000706:statistics & numerical data*; D009784:Occupational Diseases / Q000453:epidemiology* / Q000517:prevention & control; D016273:Occupational Exposure / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D013689:Telephone