AIDS TREATMENT NEWS #135, September 20, 1991
Denny Smith
The HIV Book: Information for Workers, a new edition of a handbook by the Service Employees International Union (SEIU), describes the proper precautions for healthcare workers in medical or dental settings where HIV may be present. This booklet is based on the generally accepted "universal precautions" for protecting both healthcare workers and patients from HIV and all other blood-borne infections. Universal precautions require the consistent use of sterile techniques and garments, whenever and wherever blood or body fluids may be present.
Besides providing practical precautions and addressing the concerns of healthcare workers and patients, the booklet also lists public and private health benefits available to persons with HIV, and discusses studies on the use of AZT following an accidental exposure.
To obtain copies of the handbook ($3 each for non-SEIU members) write to SEIU Health and Safety Department, 1313 L Street, N. W., Washington, D. C. 20005, or call 202/898-3443.
** New Survey of Healthcare Workers with HIV
On September 10, the Medical Expertise Retention Program (MERP) of the American Association of Physicians for Human Rights released its recent survey of HIV-positive and "high risk" untested healthcare workers. 196 physicians, nurses and dentists responded to MERP's survey, two thirds of whom have tested positive for HIV. Among the results were:
* 73% of those health workers who have HIV are afraid of losing their jobs;
* 67% have avoided seeking treatment or submitting HIV- related insurance claims;
* 65% are in their twenties or thirties, having completed their professional training only recently and acquiring large debts in the process;
* 50% believe that most of their patients would change doctors if they were told that their current provider had HIV;
* 30% provide care primarily to patients who have no private insurance.
The Director of MERP, Benjamin Schatz, notes in the report: "The loss of tens of thousands of HIV-positive health professionals would exacerbate the existing national shortage of health care workers, potentially harming all patients ...the wide-scale and seemingly punitive removal of HIV-positive health professionals would be likely to discourage people from entering the health care field. It will also diminish the overall quality of health care by fostering a climate of suspicion and fear detrimental to the health care setting ...A recent San Francisco General Hospital estimate described as 'conservative' indicates that an HIV testing and restriction program that identifies only one HIV-positive surgeon annually could cost $860,000 -- double the hospital's entire budget for infection control! And a study by the Pennsylvania Department of Health estimates that a periodic testing program for the state's health care workers would cost $54 million annually, more than twice the amount Pennsylvania spends annually on AIDS prevention."
Naphtali Offen, also of MERP, noted that "The danger of contracting HIV from your doctor is far lower than the risk of dying from other hospital-acquired infections, from pregnancy complications, or from reactions to anesthesia. Why is a risk which approaches zero being singled out for extraordinary measures? "
Complete copies of the survey results can be obtained by sending a request with $7 to MERP, 273 Church St., San Francisco, CA, 94114, or by calling 415/864-0408. Larger donations to MERP are also needed and welcomed.
Comment
Combining phrases like "knowledge of HIV status" with "criminal offense if ever there was one," Senator Jesse Helms has herded his colleagues into voting for a decade of prison and $10,000 fine for healthcare providers who know they have HIV and fail to notify their patients. His ammunition was provided by reports that a Florida dentist with HIV, Dr. David Acer, had infected five of his patients, probably through failure to observe infection control guidelines known as "universal precautions".
One dentist's disregard for universal precautions (the case of David Acer) has been transformed into a congressional disregard for civil rights (the case of Jesse Helms). Trampled in the process was the fact that public health policies can and must employ universal precautions to create a safe medical-care setting for patients as well as providers, without irrational legal requirements which divert resources and attention from responsible medical risk reduction.
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