Human immunodeficiency virus infection in the healthcare worker

The 1990 report of transmission of human immunodeficiency virus in a Florida dental office sparked a massive public fear reaction. In response, the Centers for Disease Control and Prevention produced six recommendations that provide few benefits, at what may prove to be an exorbitant cost. The author reviews those recommendations in light of the legal and ethical considerations of informed consent, significant risk, fear, confidentiality, privacy, and right to work. An alternative approach is recommended which would use human, economic, and leadership resources. This approach focuses attention on improved health care through research, product development, education, and enforcement of safety measures, and recognition and control of high-risk situations through education and government leadership.