TREATMENT WHEN SOMEONE HAS BEEN EXPOSED TO HIV
Some people, such as health care workers, have the potential to be exposed to HIV in the workplace. Despite being trained to decrease the likelihood of HIV infection through taking so-called universal precautions (using barriers to prevent contact with infected body fluids), they can nevertheless be exposed accidentally. Persons who are at the highest risk are those who sustain a needle-stick injury from a large-bore needle that has recently been used on an HIV-positive person and has visible blood on it. A person who is stuck with a needle that has sat around for an unknown length of time has a lower likelihood of becoming infected with HIV since the virus does not last long outside the body. However, because of the uncertainty, any needle stick or cut with glass or a scalpel that has been in contact with another person’s body fluids, any splash of body fluids onto mucosal surfaces, or any splash of fluid onto nonintact skin (such the site of a skin rash, scratch or scrape, or blister) should be considered a risk.
The risk of acquiring HIV from a fluid that was splashed onto broken skin has been estimated to be 3 in 1000. The risk of an exposure through a splash onto a mucous membrane is estimated to be less: under 1 in 1000. As mentioned in the section on transmission, the most potentially infectious body fluids are blood, semen, vaginal fluids, and breast milk. Fluids from which there is a doubtful risk of transmission are saliva, urine, feces, sweat, tears, and vomit, unless any of these fluids is also mixed with blood. Any other body fluids, such as fluid from the lung or amniotic fluid, could potentially transmit HIV. Fluids from a person known to be HIV-positive are more infectious if they are from one whose virus is very active, as evidenced by a high viral load assay or a low CD4 count.
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