(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
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