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HIV exposure on the job?
Nov 17, 2000

Hi. I am a med student who in July bagged vials of blood obtained from blood drawing for lab tests. Now, I am usually fastidious about wearing gloves and taking other protective measures, but due to stress and simply being busy (first med job experience), this time I did not (wear gloves).

One tube had a sticker: "ATTN so-and-so; HIV LABORATORY. I'd seen this sticker before, so the likelihood is that this was a HIV TEST vial. AS FAR AS MY FALLIBLE MEMORY permits, all i did was to pick up the tube and stuff it into the bag -- but am scared of inadvertent contact with rubber top? something I don't remember? could there be external bloodstains? what are overall risks?

I didn't give the episode any further thought that day (but I may have simply been too busy), but mid-August it popped back into my head. I have been tested at the end of Aug and Sept, standard ELISA/Western blot, and both were negative, but want to know what were my risks from the outset. My three month mark is coming up in a few weeks.

Also, I am afraid to trust the results -- I have heard of false positives and negatives, etc. Do you have figures as to the sensitivity and specificity of these tests? How much should I worry? Does the 1, 3, 6 month algorithm apply here? Please someone point me in the right direction and give me a course of action. I am afraid that if I do have HIV I might have already infected others before realizing. I have been unable to think of anything else for months. Quality of life is going to hell with the worry. Please guide.

I apologize that this post is so lengthy. Thanks!!!!

Response from Ms. Gabriel

Wow, you've got a bunch of things going on here. Let's see if I can cover them all. First, the basics. HIV can be transmitted by four body fluids: blood, semen, vaginal fluids & breast milk. One of these fluids has to come into contact with your blood stream in order to cause an infection. This can happen by (1)having unprotected sex with an infected partner; (2)sharing contaminated needles; (3)receiving infected blood; or (4)being born to an infected mother. That said, ask yourself the this question: "Did one of the four body fluids come into contact with my blood stream?" HIV does not last outside the body - exposure to heat, light and air will all kill it. In the scenario you posed, the answer is "no."

Now let's get to those other issues. You have chosen a profession in which being busy and stress are routine -- they are NOT excuses for failing to put on gloves. There can be lots of icky things in blood -- that includes the vials without the HIV LABORATORY sticker on them. Universal precautions/standards are there for a reason. Please follow them.

As to the test -- the accuracy of the standard test for the presence of antibodies to HIV (ELISA/Western Blot) is 99.8%. More accurate than many medical tests. "False negative" results can occur when the blood being tested is within the window period - the 3 1/2 weeks to 6 months that it can take the body to develop enough antibodies to show up on a test.

I hope you are find a way to deal with the stress of an incredibly rewarding, but demanding, profession that doesn't put you (or anyone else) at risk. Remember, your safety comes first. You can't help anyone without it.

Lynne Gabriel



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