Authors' objectives:

To examine evidence of the risk of HIV transmission in the health care workplace and discuss the policy implications of the U. S. Centers for Disease Control (CDC) guidelines and congressional actions in response to this risk.

Authors' results and conclusions: Estimating precise risks of HIV transmission from health care workers (HCWs) to patients is not yet possible, but the available evidence points to a very small risk, much smaller than other known medical risks, such as the risk of dying due to an adverse reaction to anesthesia during surgery. Guidelines issued by CDC in 1991 include: "universal precautions;" identification of exposure-prone procedures by professional organizations and institutions; HCWs who perform exposure-prone procedures should know their HIV and HBV (hepatitis B virus) status; and HCWs who are infected should seek counsel from an expert review panel and be advised under what circumstances, if any, they may continue to perform these procedures; and that prospective patients should be notified before undergoing exposure-prone procedures by these HIV-or HBV-positive HCWs. OTA concludes that the CDC guidelines, if widely implemented, are likely to have the intended effect of reducing further the very small risk of HIV transmission in the workplace. This would be due mainly to HCWs' improved compliance with universal precautions and to the development of improved technologies to prevent HCW injuries and blood recontacts during dental and surgical procedures. It is unclear, however, whether the recommendations concerning voluntary HCW testing, the use of expert panels, and patient notification will ultimately also contribute to a reduction in the risk of HIV transmission, since HCWs' fear of disclosure, potential discrimination, and loss of livelihood may provide a disincentive to seek appropriate counseling and testing.

Authors' recommendations: The report analyzes the issues related to CDC's guidelines for Congressional consideration.

Project Status: Completed

URL for project: http://www.wws.princeton.edu:80/~ota/ns20/pubs_f.html

Year Published: 1991

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: United States

Organisation Name: U. S. Congress. Office of Technology Assessment

Copyright: Office of Technology Assessment