HIV infection control in health care settings.

If health care workers abide by universal precautions when dealing with blood and body fluids the risk of HIV transmission from infected patients to health care workers is minimal. Few health care workers have become infected with HIV via needle stick injuries or exposure to mucous membranes. HIV-1 and HIV-2 are inactivated by heating at 60 degrees Celsius for 20 minutes by disinfectants such as 70% alcohol for 2 minutes and by high doses of ultraviolet irradiation. HIV reservoirs are blood semen vaginal secretions breast milk epithelial cells cerebrospinal fluid organs and tissues. Health care workers should concentrate on preventing needle stick injuries and injuries due to sharp instruments. Health care workers should immediately and thoroughly wash hands and other parts of the body exposed to blood and body fluids with soap and water. They should also wash hands after removing protective gloves and in between handling of patients. They should wear gloves for all direct contact with blood and body fluids and during cleaning and decontaminating procedures. A face shield or mask eye glasses and waterproof gowns should be worn during all procedures where splashing of blood may occur. No one should perform mouth pipetting of blood or other body fluids. Health workers should reduce the number of unnecessary injections. They should use single-use syringes and needles and discard of them in puncture-proof containers. If single-use equipment is not available all equipment needs to be autoclaved before reuse. If a wound occurs due to injury from contaminated equipment bleeding should be encouraged. The health care worker must also wash it with soap and much water. Health care workers should immerse vaginal speculums proctoscopes nasal speculums and instruments used for laryngeal and tracheal exams in a suitable disinfectant (e.g. embalming fluid) for at least 20 minutes.