An ongoing dialogue on HIV/AIDS, infectious diseases,
June 13th, 2009
Occupational Exposures and HIV Testing
A couple of years ago, an ID-colleague of mine told me about a tough case: While working in the ICU, an anesthesiologist sustained a pretty severe needle stick. Approached for HIV testing, the source of the exposure felt threatened by the providers in the ICU, and refused to sign the consent.
The patient then deteriorated and required intubation. The intensivist, understandably in something of a panic, contacted my colleague for advice.
We’re about to post this case — actual details of which are slightly changed to protect anonymity — in AIDS Clinical Care. We’ve asked some experts (MD, lawyer, ethicist) on the matter a few key questions, including:
- How would you manage the intensivist who sustained the injury?
- Would you give post-exposure prophylaxis? If so, what specifically would you give, and for how long?
- How would you determine if the source patient has HIV? Would you perform surrogate testing (for example, obtain a CD4-cell count) to assess this? Would you consider testing him without written informed consent?
- If he is tested, would you give him the results after he recovers if the test is negative? If the test is positive?
And it’s a reminder that amidst all the controversy over “opt-out” testing and HIV screening, there’s another big issue out there regarding HIV testing that’s hardly been settled.
Categories: Antiretroviral Rounds, Health Care, HIV, Infectious Diseases, Patient Care, Policy
Tags: AIDS, aids clinical care, cd4 cell count, HIV, HIV testing, informed consent, intensivist, occupational exposures, post-exposure prophylaxis
You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed.
Paul E. Sax, MD
Learn more about HIV and ID Observations.
Follow HIV and ID Observations Posts via Email
- ID Cartoon Caption Contest (125)
- ID Cartoon Caption Contest #2 Winner — and a New Contest for the Holidays (92)
- Dear Nation — A Series of Apologies on COVID-19 (80)
- How to Induce Rage in a Doctor (77)
- IDSA’s COVID-19 Treatment Guidelines Highlight Difficulty of “Don’t Just Do Something, Stand There” (74)
- How Accurate Are Home Antigen Tests for Omicron?
- Does COVID-19 Confer Risk for Venous Thromboembolism in Ambulatory Patients?
- American Heart Association Statement: Managing Infective Endocarditis in People Who Inject Drugs
- Preventing Thrombotic Complications in Severe COVID-19: Full-Dose or Standard-Dose Anticoagulation?
- Pharmacokinetics of Ceftaroline in the Central Nervous System Are Favorable for Meningitis Therapy
- Abacavir AIDS antibiotics antiretroviral therapy ART atazanavir baseball CDC C diff COVID-19 CROI cure darunavir dolutegravir elvitegravir etravirine FDA HCV hepatitis C HIV HIV cure HIV testing ID fellowship ID Learning Unit Infectious Diseases influenza Link-o-Rama lyme disease MRSA PEP Policy PrEP prevention primary care raltegravir Really Rapid Review resistance Retrovirus Conference rilpivirine sofosbuvir TDF/FTC tenofovir Thanksgiving vaccines zoster