AIDS Continuing Education--NCBTMB Approved

Chapter 2

Infection Control Procedures


The first rule of preventing the virus from entering the body is: don’t. Don’t share contaminated needles. Don’t be pricked by a needle. Don’t engage in unprotected sex. Don’t breastfeed if you are infected.


3 Cornerstones to Infection Control

  • Don’t engage in dangerous behaviors
  • Barriers
  • Sterilization or disposal


    • The second rule of prevention is barriers. Gloves should be worn by any person with a risk of exposure to HIV-potential fluids. Exposure might include open skin lesions on a patient/client or handling blood, items soiled by blood or other HIV-possible fluids. Gloves should be disposed of, hands washed and new gloves donned before a new client/patient is seen. Face masks and protective eyewear may be appropriate in certain circumstances. If ungloved hands touch any HIV-potential fluid, the hands should be immediately and thoroughly washed.


    The third rule is sterilization or disposal. Instruments coming into contact with HIV-potential fluids should either be one-use and immediately disposed of with proper care after use or be sterilized after each use. All surfaces and equipment in the room should be disinfected after each use; these include “…chairs, mirrors, counter tops, drawer handles, …and light handles.” Disposable items and articles soiled with blood require special disposal such as that accorded infectious waste. Used needles should be placed in a puncture-resistant container dedicated solely to this purpose. Needles should not be bent or recapped first; the latter is a frequent cause of puncture injuries. Blood spills require prompt cleaning with sodium hypochlorite or other disinfectant solution.


    Breach of infection control procedures resulting in possible exposure to HIV optimally should be verified by rapid HIV testing of the source. Reevaluation of the situation should occur 72 hours after possible infection.


    If infection is indicated, the infectee should receive a four week regimen of antiretroviral agents. This course should begin within hours of possible infection. Many persons do not complete the full term of the drugs, some because of substantial side effects. A quarter of the patients experienced nausea and a fifth reported fatigue. Administering this regimen during pregnancy is an additional concern. Optimally, the primary physician should consult with one experienced in infectious diseases and/or antiretroviral agents but regime initiation should not be delayed to do so.


    Along with the antiretroviral course (and even if it is refused), the infectee should be offered counseling and evaluation. Follow up testing should occur at 6 weeks, 12 weeks and 24 weeks.


    If the regimen is accepted, the infectee should be reviewed for drug toxicity at 2 weeks after possible infection.



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