Published December, 2013

Occupationally Acquired Human Immunodeficiency Virus (HIV) Infection: National Case Surveillance Data During 20 Years of the HIV Epidemic in the United States, Do et al., Infection Control and Hospital Epidemiology (2003)

This article explores the incidence of occupationally acquired HIV in health care and laboratory settings in the United States. The study analyzed case data from two surveillance mechanisms, the HIV/AIDS Reporting System and the National Surveillance for Occupationally Acquired HIV Infection. These data include only voluntary case reporting from health care and laboratory workers in the United States. The reported data reveals that as of 2001, 57 health care workers were documented as having occupational acquisition of HIV. Since national reporting requirements for HIV and AIDS are different, the data primarily looked at AIDS cases; however, the researchers fluctuated in their use of “HIV” and “AIDS,” which creates confusion in their analysis.

In order to prove occupational acquisition, workers must show a temporal connection between an exposure event and a positive test without any outside events that may have put them at risk for HIV infection. Eighty-six percent were exposed to blood, and 88 percent had percutaneous injuries (sharps/needle sticks). Such injuries most often occurred following a procedure rather than during the disposal of sharp objects. Of the 55 patients involved in these transmissions, most had AIDS at the time of incident. Eight of the 57 workers seroconverted despite using post-exposure prophylaxis (PEP).

Based on their findings, the authors recommend greater emphasis on prevention efforts including broader understanding and use of PEP, and stronger adherence to existing infection control procedures. In addition, they advocate for the exploration of more advanced technology to reduce transmission risk in the workplace. It should be noted that since the publication of this article, further information on PEP has been released, including the Centers for Disease Control’s 2013 Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HIV and Recommendations for Postexposure Prophylaxis. In addition, further data reporting through 2010 indicate that the number of reported seroconversion cases remains at 57.