Important note: Information in this article was accurate in 2002. The state of the art may have changed since the publication date. I know this question I'm about to ask may seem off the subject of the normal questions you receive, but I have a friend whose husband is HIV positive and has been for over 10 years. They have two children who were conceived after he was already infected. She claims that she doesn't have HIV. Anyway, she's going to school right now to become a nurse. It bothers me that she may be putting the other students at risk of becoming infected, being that our school practices injections, blood glucose testing, blood withdrawals, and IV insertions on a student to student basis. I realize going into the medical field that we're going to come across HIV infected individuals everyday, but is she compromising the lives of the other students by being enrolled in our school? And am I being a good friend by not letting any of the staff at our school know this or am I contributing to the problem? Please give me some insight on the statistics on medical workers infected in the medical field!
Signed, A concerned Future Nurse
Lisa Capaldini, M.D.
Internal Medicine
The simple good news is that your nurse-to-be pal is at NO risk of passing HIV onto patients or nursing colleagues.
Firstly, to transmit HIV, a person has to be HIV-infected. While it may seem implausible that someone could have regular intimate contact with an HIV-positive partner and remain negative, it's a common reality. In fact the whole basis of practicing safe sex is to prevent HIV transmission between partners, and, it works. I have many, many couples in my practice who are "HIV discordant," that is one is positive and one is negative.
And when they practice safe sex, they stay that way.
Now, let's change the scenario: let's say your nursing student friend is in fact HIV-positive. In that situation, what risks are involved?? Theoretically, she could transmit HIV to a patient or colleague if her blood landed on open skin of another person. This, for example, could happen during surgery if the surgeon accidentally cut through her glove and she bled through the glove. But HIV is not unique in this: Hepatitis B and hepatitis C could also be transmitted this way, and in fact are MORE transmissible than HIV in this specific context. That's why ALL health workers are instructed in "Universal Precautions": This means we assume ANY patient could be infected with HIV/hepB/hepC and that ANY healthworker can be carrying HIV/hepB/hepC. Through data collected from the CDC since l985, we know that with the implementation of universal precautions, HIV transmission within the health-care setting is extremely low AND that the only documented cases of transmission between patients and caregivers has been patients infecting caregivers.
I have HIV-positive colleagues who are nurses, doctors, and lab techs, and know that through they and everyone else using universal precautions, they pose no risk to me or my other colleagues or my patients.
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