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HIV transmission in the medical setting
HIV/AIDS community should stop bickering over details of modes of transmission and address unsafe medical practices urgently
Authors:
E. Friedman
Publisher:
Physicians for Human Rights, 2003
This paper calls for human rights law to be applied equally across developed and developing nations, which means that people in poorer countries should be able to access safe health care. The paper states that currently this is not the case in many settings because:
- people living with HIV are often discriminated against, leading them not to access health care facilities
- some health care providers refuse treatment due to fear or lack of knowledge or equipment
The paper therefore calls for immediate efforts to increase injection safety, the safety of blood supplies, and adherence to universal precautions in order to prevent infections from unsafe injections, transfusions of contaminated blood, and HIV transmission between patient and health care provider. The authors state however, that the urgency of action needed to reduce the risks of transmitting HIV through the medical setting does not suggest any lessening in the importance of decreasing sexual transmission. These efforts also must be scaled up significantly and urgently. The experience of Uganda demonstrates that it is possible to educate people on the risks of infection through unsafe injections while still achieving significant behavioral changes to reduce HIV transmission through sexual behavior.
The authors then discuss means of HIV transmission in the medical setting and describe the risks, scale of the problem and ways of eliminating risk. The means of transmission discussed are:
- unsafe injections
- multi-dose vials
- sterilization of equipment
- blood transfusions
- universal precautions, which are general infection control measures to prevent transmission to and from health care workers
The paper provides recommendations for donors, governments, the WHO and other agencies to address problems with means of transmission outlined above. They call on the international community not to argue over details, referring to controversy over numbers of people infected in medical settings vs. those infected through unsafe sex, but to urgently address medical transmission as a priority, as well as continuing their focus on behaviour change.
[adapted from author]
