Preventing HIV transmission. Strategies to protect clinicians and patients

Human immunodeficiency virus (HIV) transmission to healthcare workers arises primarily from percutaneous injury by sharp devices recently contaminated with infected blood. The danger is small but real, and substantial effort to reduce this risk is justified. The risk of transmission to patients from HIV-infected healthcare workers is much smaller. Attempts to accommodate measures to control this risk in standard protocols has engendered considerable debate. The discrimination and loss of insurability attendant to HIV infection also complicate the application of control measures. Where possible, procedures appropriate in cases involving known HIV infection should be applied in all situations. Acquiring tuberculosis from HIV-infected patients probably presents a greater hazard to healthcare workers than becoming infected with HIV itself.