|HIV in Pregnancy: A Review (UNAIDS, 1999, 67 p.)|
|SECTION C : INFECTION CONTROL MEASURES|
(See Guidance Module on Antiretroviral Treatments, Module 7. Treatments following exposure to HIV)
Exposure to blood and other body fluids is common in obstetric practice382,383,384,385,386 and staff should receive information, training and access to equipment in order to protect themselves387. In areas of highest HIV prevalence, tests may not be available and many women will also be in the "window period" before seroconversion, and may not be identified by routine HIV-antibody tests. Lack of access to nosocomial infection prevention measures may unfortunately be common in these countries388,389,390. A study of occupational exposure in the United Republic of Tanzania showed that health workers were exposed on average to five sharp injuries and nine splashed exposures each year, with a higher risk in surgeons391. In Rwanda, no evidence was found for any HIV infection caused by occupational blood contact in 215 traditional birth attendants, exposed to an estimated 2234 potentially infectious blood-skin contacts over five years392.
All patients should be regarded as potentially infectious, not only for HIV, but also for Hepatitis and other pathogens393,394. Health care workers must ensure that they use universal precautions against accidental infection at all times. These require the provision within health services of protective devices and clothing and access to safe containers for sharp instruments395.