It seems like after the AIDS epidemic of the 1980s made its way out of the mainstream news, conversations, and concerns from the general public regarding HIV and AIDS dwindled. We might hear about it once a year on World Aids Day, or when someone famous decides to come out about the fact that they have it. Otherwise, it’s another one of those important subjects that society tends to sweep under the rug. Yet, the virus is still very much alive, with 1.1 million people in the U.S living with HIV and 1 in 7 of them not knowing it, according to the Centers for Disease Control and Prevention (CDC). It’s not an easy thing to talk about, not only because of the stigma attached to it but because of the damage it can do to those who contract it. As locum tenens physicians, you’re used to having difficult conversations and conversations about HIV should be one of them. Although the risk of occupational exposure to HIV in healthcare settings is very small, there are precautions you can take to protect yourself. It’s also important that you, as a physician, understand recent medical advances in HIV to help your patients. Most importantly, you should know how to talk to your patients about risk factors and getting tested for HIV. So, let’s talk about it.
Occupational Exposure to HIV in Healthcare Settings: The Statistics
In the medical field, occupational exposure to HIV in healthcare settings is very rare but still thought about and discussed, especially for those who are working infectious disease physician jobs. The HIV occupational exposure statistics are surprisingly low. As of December 2013, there were only 58 confirmed occupational transmissions of HIV ever, according to the CDC. Only one of those 58 confirmed cases happened after 1999. Yet, reporting of this is voluntary, so it is possible that occupational exposure to HIV in healthcare settings is underreported, the CDC said. Even still, there are many precautions physicians take to protect themselves on the job such as wearing gloves and goggles, constantly washing their hands and making sure that all of the equipment is sterilized after every patient.
Hope for HIV: Recent Medical Advances
Today there are many medical advances happening for HIV that lower risk of transmission, improve patient treatment and that could potentially lead to a cure. For example, recently there’s been an influx of news article about HIV. A trial from the New England Journal of Medicine found that a new combo of drugs to treat HIV lowered deaths by 27 percent. Another trial has discovered a vaginal ring for teenage girls to wear that could lower their risk of contracting HIV, as women ages 15-24 account for 1/5 of all new HIV infections globally. Nearly 1,000 women are infected every day in sub-Saharan Africa.
Most importantly, a cure for HIV may have been discovered. A South African child who was infected near birth has remained free of the virus for 8.5 years after receiving early treatment, giving scientists hope that a cure for adults is in sight. It’s also important to note that HIV is one of those often overlooked symptoms of the opioid epidemic. Although many experts are comparing today’s opioid epidemic to the AIDS epidemic, opioids are also creating an increasing threat to the progress made in fighting HIV because of heavy needle use.
Talking to Patients about HIV
Not only is it important to protect yourself against occupational exposure to HIV in healthcare settings, but it’s also important to talk to your patients about HIV. Locum tenens physicians working in general, family practice or obstetrics and gynecology are most likely the ones to discuss HIV with their patients, and play a critical role in preventing the spread of HIV. Here are a couple tips for talking to patients about HIV:
1. Screen Everyone.
Whether you feel that your patient is considered to be at-risk of contracting HIV or not, it is important to encourage them to get tested for the virus. With 1 in 7 people unaware that they have HIV, the CDC recommends that every American between the ages of 13 and 64 be routinely screened for HIV. Knowing you have HIV is the first step in lowering the chances of spreading it to others. Of course, HIV screening is voluntary and completely up to the patient, but the simple act of suggesting someone gets tested can start the conversation about HIV and prevention.
2. Push Prevention.
In order to push the idea of prevention onto your patients, it means having the basic safe sex talk with them such as: use condoms; ask your partner about their sexual history; get tested regularly. Then there are the tips more specific to HIV transmissions, such as don’t share things like tooth brushes or needles. Prevention is a conversation that can happen whether your patient already has HIV or not. If they don’t have it yet, it’s important that they know how to lower their chances of getting it. If they have it, it’s important that they know how to prevent transmission to their partner.
How often do you think about or discuss ways to prevent occupational exposure to HIV in healthcare settings? What are some ways you go about talking to patients about HIV?