Prevention of HIV infection in healthcare workers. What should an employer do if an employee has HIV? Rules for working with HIV
»» №4 2001 Dangerous infections
Acquired Immune Deficiency Syndrome (AIDS) is the most dangerous infectious disease leading to death on average 10-11 years after infection with the human immunodeficiency virus (HIV). According to UN data published in early 2000, the HIV/AIDS pandemic has already claimed the lives of more than 18 million people and today there are 34.3 million HIV-infected people in the world.
As of April 2001, 103,000 HIV-infected people were registered in Russia, and in 2000 alone, 56,471 new cases were detected.
The first reports of patients with HIV infection appeared in the newsletter of the Center for Disease Control (Atlanta, Georgia, USA). In 1982, the first statistics on AIDS cases detected in the United States since 1979 were published. An increase in the number of cases (in 1979 - 7, in 1980 - 46, in 1981 - 207 and in the first half of 1982 - 249) indicated an epidemic the nature of morbidity, and high mortality (41%) spoke of the increasing importance of infection. In December 1982, a case of AIDS associated with blood transfusion was published, suggesting the possibility of a "healthy" carriage of an infectious agent. An analysis of AIDS cases in children has shown that children can receive the agent that causes the disease from an infected mother. Despite treatment, AIDS in children progresses extremely rapidly and inevitably leads to death, which gives reason to consider the problem of extraordinary importance.
Currently, three ways of HIV transmission have been proven: sexual; through parenteral administration of the virus with blood products or through infected instruments; intrauterine - from mother to fetus.
Quite quickly, it was found that HIV is extremely sensitive to external influences, dies when using all known disinfecting agents, and loses activity when heated above 56°C for 30 minutes. Solar, UV and ionizing radiation are detrimental to HIV.
The highest concentration of the AIDS virus was found in blood, semen, and cerebrospinal fluid. In smaller quantities, it is found in saliva, breast milk, cervical and vaginal secretions of patients.
With the increase in the number of HIV-infected and AIDS patients, the demand for medical care, including those requiring both emergency and planned surgical intervention, increases.
Taking into account the peculiarities of the course of HIV infection, it is impossible to deny with certainty that this or that patient does not have it. For medical personnel, each patient should be considered as a possible carrier of a viral infection. In all cases of possible contact with the patient's biological fluids (blood, wound discharge, discharge from drains, vaginal secretions, etc.), gloves must be used, hands should be washed and disinfected more often, a mask, goggles or a transparent eye shield should be used. Do not take part in work with patients in the presence of abrasions on the skin of the hands or superficial skin defects.
The danger of infection of medical personnel really exists if the generally accepted rules of asepsis and hygiene are violated during the performance of medical and diagnostic procedures.
Data have been published where, in order to determine the risk of infection of medical workers, surveys of large groups of doctors (from 150 to 1231 people) were conducted, who did not follow the precautions. The frequency of HIV infection was 0% when the infected material came into contact with intact skin, 0.1-0.9% - with a single hit of the virus under the skin, on damaged skin or mucous membranes.
Glove punctures occur in 30% of operations, wounding the hands with a needle or other sharp object - in 15-20%. When the hands are injured by needles or cutting instruments infected with HIV, the risk of infection does not exceed 1%, while the risk of infection with hepatitis B reaches 6-30%.
Since 1992, on the basis of the Infectious Clinical Hospital No. 3, there have been beds in the surgical department for providing surgical care to HIV-infected and AIDS patients with concomitant surgical pathology. Over the past period, 600 patients were hospitalized in the department, 250 of them were operated on.
The department provides for a treatment room, a dressing room and an operating room, where assistance and operational benefits are provided only to HIV-infected and AIDS patients.
For all admitted patients, intramuscular injections and any manipulations with blood are carried out by medical personnel only in the treatment room in gowns, hats, and gloves specially provided for these cases. If there is a threat of splashing of blood or other biological fluid, it is necessary to work in a mask and goggles. We use regular latex gloves (two pairs), special goggles and non-woven gowns. Blood during intravenous sampling is collected in test tubes with tightly closed stoppers. All test tubes are necessarily marked with the initials of the patient and the inscription "HIV". Referral sheets to the laboratory when taking blood, urine, biochemical studies are marked with an indication of the presence of HIV infection. These forms are strictly forbidden to be placed in test tubes with blood.
Urinalysis is given in a container with a tight-fitting lid and is also marked with a message indicating the presence of HIV infection. Transportation is carried out in a closed box marked "HIV".
In case of contamination of gloves, hands or exposed areas of the body with blood or other biological materials, they should be treated for 2 minutes with a swab abundantly moistened with an antiseptic solution (0.1% deoxone solution, 2% hydrogen peroxide solution in 70% alcohol, 70% alcohol ), and 5 minutes after treatment, wash in running water. If the surface of the table, hand pads during intravenous infusion, tourniquet are contaminated, they should be immediately wiped with a rag moistened with a disinfectant solution (3% chloramine solution, 3% bleach solution, 4% hydrogen peroxide solution with 0.5% detergent solution). ).
After use, the needles are placed in a container with a disinfectant solution. This container must be in the workplace. Before immersing the needle, the cavity is washed with a disinfectant solution by sucking it with a syringe (4% hydrogen peroxide solution with 0.5% detergent solution - 3% chloramine solution). Used syringes and gloves are collected in a separate container specially designed for them and disinfected.
We use analyte solutions or 3% chloramine solution. Exposure 1 hour.
If there is a suspicion that the infected material has entered the mucous membranes, they are immediately treated: the eyes are washed with a stream of water, a 1% solution of boric acid, or a few drops of a 1% solution of silver nitrate are injected. The nose is treated with a 1% solution of protargol, and if it gets into the mouth and throat, it is additionally rinsed with 70% alcohol or a 0.5% solution of potassium permanganate, or a 1% solution of boric acid.
If the skin is damaged, you must immediately remove the gloves, squeeze out the blood, and then thoroughly wash your hands with soap and water with running water, treat them with 70% alcohol and lubricate the wound with 5% iodine solution. If infected blood gets on your hands, you should immediately treat them with a swab moistened with a 3% solution of chloramine or 70% alcohol, wash them with running warm water and soap and dry them with an individual towel. Start prophylactic treatment with AZT.
At the workplace, an accident report is drawn up, this fact is reported to the center dealing with the problem of HIV infection and AIDS. For Moscow, this is infectious diseases hospital No. 2.
The treatment room is cleaned at least 2 times a day with a wet method using a disinfectant solution. Cleaning rags are disinfected in a 3% solution of chloramine, an analyte, for an hour. Washes and dries. Gastric and intestinal probes used in preparation for surgery and diagnostic manipulations after the studies are also processed in an analyte solution or 3% chloramine solution with an exposure of 1 hour. Dried and handed over to autoclaving for further use.
The operating field in patients is prepared using individual disposable razors.
Special precautions must be observed during operations. Medical personnel who have skin lesions (cuts, skin diseases) should be exempted from direct treatment of patients with HIV infection and the use of equipment in contact with them. As protection during the operation in our department, surgeons, anesthesiologists and operating nurses use plastic aprons, shoe covers, oversleeves, disposable gowns made of non-woven material.
Goggles are used to protect the mucous membrane of the eyes, double masks are used to protect the nose and mouth, and two pairs of latex gloves are put on the hands. During operations of HIV-infected and AIDS patients, instruments are used that are used only for this category of patients and are labeled "AIDS". Sharp and cutting instruments during the operation are not recommended to be transferred from hand to hand. The surgeon himself must take the instruments from the table of the operating nurse.
After the operation, the instruments are washed from biological contaminants in a closed container with running water, then disinfected with a 5% solution of lysetol with an exposure of 5 minutes, a 3% solution of chloramine with an exposure of 1 hour. Next, the instruments are washed with running water and rinsed with distilled water, followed by drying, after which they are handed over for autoclaving.
Dressing gowns are disposable. After the operation, the gowns are kept in an analyte solution, 3% chloramine solution with an exposure of 1 hour, after which they are destroyed. Plastic aprons, shoe covers, sleeves are processed in an analyte solution, 3% solution of chloramine, alaminol with an exposure of 1 hour, washed with running water, dried and reused.
The operating room is processed after the performed manipulations: current cleaning is carried out with analyte solutions, 3% hydrogen peroxide solution.
Bandaging of patients in the postoperative period, as well as manipulations that do not require anesthesia, are carried out in a dressing room specially designed for this category of patients. The surgeon and dressing nurse dress in the same way as for the operation. The instruments are marked "HIV" and are only used for bandaging HIV/AIDS patients. Handling of used material, instruments and cabinet is carried out in the same way as in the operating room.
With the increase in the number of HIV-infected and AIDS patients, the number of requests for medical care by this category of patients is growing.
When contacting a patient, one should proceed from the premise that all incoming patients are HIV-infected, and strictly implement appropriate preventive measures.
Effective prevention of HIV infection is possible only with the daily training and education of medical personnel. This will allow you to overcome the fear of contact with an HIV-infected patient, to act competently and confidently.
This is the key to the professional safety of medical workers.
T.N. BULISKERIA, G.G. SMIRNOV, L.I. Lazutkina, N.M. VASILIEVA, T.N. SHISHKARVA
Infectious Clinical Hospital No. 3, Moscow
Ethyl alcohol solution 70% - 50.0
Alcohol solution of iodine 5% - 10.0
Sterile cotton balls in sealed packaging
Actions of a medical worker in an emergency.
In each medical institution, an Algorithm for the action of medical personnel in an emergency should be developed and based on:
Sanitary and epidemiological rules SP 3.1.5. 2826-10 Prevention of HIV Infection
Information letter dated 01.11.2010 "The procedure for post-exposure prophylaxis of HIV infection in the medical and preventive institutions of the Udmurt Republic."
Preventive measures in case of contact with infectious biological liquids infected with HIV on the skin and mucous membranes, as well as in case of injections and cuts:
In accordance with paragraph 8.3.3.1. SP 3.1.5. 2826-10:
In case of cuts and pricks immediately:
Take off the gloves
Wash your hands with soap under running water,
Clean hands with 70% alcohol
Lubricate the wound with a 5% alcohol solution of iodine;
If blood or other biological fluids come into contact with the skin:
This place is treated with 70% alcohol,
Wash with soap and water and re-treat with 70% alcohol;
If blood and other biological fluids of the patient get on the mucous membranes of the eyes, nose and mouth:
Rinse mouth with plenty of water
Rinse with 70% ethyl alcohol solution,
The mucous membrane of the nose and eyes are washed with plenty of water (do not rub);
If blood and other biological fluids of the patient get on the dressing gown, clothes:
Remove work clothes and immerse in a disinfectant solution or in a bix (tank) for autoclaving;
Note:
Start taking antiretroviral drugs as soon as possible for post-exposure prophylaxis of HIV infection.
Examination of an injured healthcare worker after an emergency.
In accordance with clause 8.3.3.2. SP 3.1.5. 2826-10 it is necessary as soon as possible after contact to examine for HIV and viral hepatitis B and C a person who may be a potential source of infection and a person in contact with him. An HIV examination of a potential source of HIV infection and a contact person is carried out by rapid testing for antibodies to HIV after an emergency with the obligatory sending of a sample from the same portion of blood for standard HIV testing in ELISA. Blood plasma (or serum) samples of a person who is a potential source of infection, and a contact person, are transferred for storage for 12 months to the BHI UR "URC AIDS and IZ".
The victim and the person who may be a potential source of infection should be interviewed about the carriage of viral hepatitis, STIs, inflammatory diseases of the urogenital area, and other diseases, and counseling regarding less risky behavior. If the source is infected with HIV, find out if he received antiretroviral therapy. If the victim is a woman, a pregnancy test should be done to see if she is breastfeeding. In the absence of clarifying data, post-exposure prophylaxis is started immediately, with the appearance of additional information, the scheme is adjusted.
Carrying out post-exposure prophylaxis of HIV infection with antiretroviral drugs, in accordance with SP 3.1.5. 2826-10:
Clause 8.3.3.3: The decision to conduct post-exposure prophylaxis for HIV infection is made by the doctor responsible for managing patients with HIV infection in the health facility where the emergency occurred. On weekends, holidays and on the night shift, the doctor on duty of the department where the emergency occurred, with the subsequent referral of the injured employee for a consultation to the infectious disease specialist for correction of ART.
Clause 8.3.3.3.1: Antiretroviral drugs should be started within the first two hours after the accident, but no later than 72 hours.
In each health facility, a specialist responsible for the storage of ARVs must be determined by order of the head physician, a storage location for ARVs must be determined to ensure their availability around the clock, including at night and on weekends.
Clause 8.3.3.3.2: The standard regimen for post-exposure prophylaxis of HIV infection is lopinavir/ritonavir + zidovudine/lamivudine. In the absence of these drugs, any other antiretroviral drugs can be used to start chemoprophylaxis; if a full-fledged HAART regimen cannot be started immediately, one or two available drugs are started. The use of nevirapine and abacavir is possible only in the absence of other drugs. If the only available drug is nevirapine, only one dose of the drug, 0.2 g, should be prescribed (repeated administration is not allowed), then when other drugs are received, full chemoprophylaxis is prescribed. If abacavir is started on chemoprophylaxis, testing for abacavir hypersensitivity reaction or switching from abacavir to another NRTI should be done as soon as possible.
Registration of an emergency is carried out in accordance with the established requirements in accordance with SP 3.1.5. 2826-10:
Clause 8.3.3.3.3:
1. Employees of the medical facility must immediately report each emergency to the head of the unit, his deputy or a higher manager;
2. Injuries received by medical workers, and resulting in at least 1 day of disability or transfer to another job, should be taken into account in each health facility and acted as an accident at work with the preparation of an Act on an accident at work (in 3 copies), on on the basis of the Decree of the Ministry of Labor of the Russian Federation of October 24, 2002 No. 73 "On approval of the forms of documents necessary for the investigation and accounting of industrial accidents, and the provisions on the features of the investigation of industrial accidents in certain industries and organizations"
3. you should fill in the Journal of registration of accidents at work;
4. it is necessary to conduct an epidemiological investigation of the cause of the injury and establish a connection between the cause of the injury and the performance of the medical worker's duties;
5. All other emergencies are recorded in the "Emergency Register of the Health and Preventive Institution" with the execution of the Emergency Act in 2 copies.
Clause 8.3.3.3.4:
All health facilities should be provided with, or have access to, rapid HIV tests and antiretrovirals when needed. A stock of antiretroviral drugs should be kept in any health facility in such a way that examination and treatment can be organized within 2 hours after an emergency. A specialist responsible for the storage of antiretroviral drugs, a place for their storage with access, including at night and on weekends, should be identified in the health facility.
Clause 5.6:
Examination of an affected health worker for HIV infection is carried out with mandatory pre- and post-test counseling on HIV prevention.
Clause 5.7:
Counseling should be carried out by a trained specialist (preferably an infectious disease doctor, epidemiologist or psychologist) and include the main points regarding HIV testing, the possible consequences of testing, determining the presence or absence of individual risk factors, assessing the knowledge of the examinee about HIV prevention, providing information about the ways of HIV transmission and ways of protection from HIV infection, types of assistance available for those infected with HIV.
Clause 5.8:
When conducting pre-test counseling, it is necessary to fill out an informed consent form for an examination for HIV infection in two copies, one form is given to the examinee, the other is stored in the health facility.
Surveillance of contacts receiving HIV chemoprophylaxis.
A medical worker or a person injured in an emergency after an episode of emergency contact with a source of infection must be observed for 12 months by an infectious disease specialist of the BHI UR "URC for AIDS and IZ" or an infectious disease specialist at the place of work (place of medical care) with control periods repeated testing for HIV, HCV, HBV at 3, 6 and 12 months after exposure.
To identify adverse events associated with taking drugs, a laboratory examination is performed: complete blood count, biochemical blood test (o. bilirubin, ALT, AST, amylase / lipase). The recommended frequency of examination: after 2 weeks, then after 4 weeks from the start of chemoprophylaxis.
It is necessary to provide psychological support and, if necessary, refer the contacted person for a consultation with a psychologist/psychotherapist of the Infectious Diseases Institution of Ukraine UR "URC AIDS and IZ" at his request.
Precautionary measures.
- 1. All manipulations in which hands may become contaminated with blood, serum or other biological fluids should be carried out with rubber gloves.
- 2. When performing manipulations, the medical worker must be dressed in a gown, cap, removable shoes, which is prohibited outside the manipulation rooms.
- 3. Health care workers with wounds on their hands, exudative skin lesions or weeping dermatitis are suspended from patient care and contact with patient care items for the duration of the disease. If it is necessary to perform work, all damage must be covered with fingertips, adhesive tape.
- 4. If there is a threat of splashing of blood or serum, eye and face protection, a protective mask, goggles, and protective shields should be used.
- 5. Disassembly, washing, rinsing of medical instruments, pipettes, laboratory glassware, devices or devices that have come into contact with blood or serum should be carried out after preliminary disinfection (decontamination) and only with rubber gloves.
- 6. All manipulations with an HIV-infected patient must be performed in the presence of a second specialist who, in the event of an emergency, can provide assistance to the victim, and also continue the manipulation.
- 7. The healthcare worker should treat blood and other bodily fluids as potentially infectious material.
To reduce the likelihood of professional infection with HIV infection, when preparing to perform manipulations on an HIV-infected person, medical personnel must ensure the integrity of the first-aid kit, carry out manipulations in the presence of another specialist who, in the event of a rupture of a rubber glove or a cut, can continue to perform medical manipulations, do not rub the mucous membranes with their hands shells.
1. If contact with blood, biological fluids or biomaterials was accompanied by a violation of the integrity of the skin (prick, cut), then the victim must:
a) remove gloves with a working surface inside;
b) squeeze blood out of the wound;
c) treat the damaged area with one of the disinfectants (70% ethyl alcohol solution, 5% iodine tincture for cuts, 3% hydrogen peroxide);
d) wash your hands thoroughly with soap under running water, and then wipe them with a 70% solution of ethyl alcohol;
e) put a plaster on the wound, put on a fingertip;
f) if necessary, continue to work, put on new rubber gloves;
g) urgently inform the management of the medical institution about the accident for its registration and emergency prevention of HIV infection.
2. In case of contamination with blood, biological fluids, biomaterials without skin damage:
a) treat the site of contamination with one of the disinfectants (70% ethyl alcohol solution, 3% hydrogen peroxide solution, 3% chloramine solution);
b) wash with soap and water and re-treat with alcohol.
3. In case of contact with blood, biological fluids, biomaterial on the mucous membranes, rinse the oral cavity with a 70% solution of ethyl alcohol, drip the nasal cavity with a 30% solution of albucid, rinse the eyes with water (clean hands), drip with 30% albucid solution. A 0.05% potassium permanganate solution can be used to treat the nose and eyes.
4. In case of contact with blood, biological fluids, biomaterial on a dressing gown, clothes:
remove clothes and soak in one of the disinfectants;
wipe the skin of the hands and other parts of the body if they are contaminated through clothing with a 70% solution of ethyl alcohol, and then wash with soap and water and wipe again with alcohol;
wipe contaminated shoes twice with a cloth soaked in a solution of one of the disinfectants.
Post-exposure prophylaxis
Post-exposure prophylaxis (PEP) is a short-term course of antiretroviral drugs to reduce the likelihood of developing HIV infection after exposure to body fluids associated with the risk of infection (in the workplace, through sexual contact, or from a needle stick).
PEP with antiretroviral drugs should be started as early as possible, preferably within the first 2 hours after exposure, but no later than 72 hours. To do this, the health worker is assigned a four-week course of antiretroviral chemoprophylaxis, during which the following is carried out: control over the possible occurrence of side effects of drugs; re-examination for HIV after 1, 3 and 6 months after exposure. If a healthcare worker seroconverts during this period, then he needs to be provided with the necessary assistance, including counseling, referral to an HIV specialist and long-term treatment for HIV. If seroconversion has not occurred within six months after exposure, inform the health worker that he does not have HIV infection.
HIV or Acquired Immunodeficiency Syndrome is a disease against the background of severely reduced immunity, unable to withstand the onslaught of any, even the most primitive infection. Unfortunately, society still treats people with HIV-positive status with apprehension and distrust, and they do not know whether it is possible to work with HIV infection in a particular production. This significantly reduces the range of professions for patients and there are many problems in finding a job. In fact, doctors do not tire of repeating that an HIV-infected person is not dangerous to others and only 3 ways of transmitting HIV are officially confirmed, and even at its low concentration, the virus is unlikely to become a source of infection for a healthy person with stable immunity.
HIV is transmitted:
- sexually;
- when using one needle (this is common among drug addicts);
- due to transfusion of infected blood from a sick carrier to a healthy one;
- in rare cases - from HIV pregnant women to the fetus.
The virus is not transmitted through kisses, handshakes, coughing, saliva, eating and drinking from the same dish, visiting public places: baths, saunas, swimming pools, transport.
HIV infection does not survive long in the environment. These are unfavorable conditions for her and death quickly sets in. Even after an injection with a contaminated needle, the virus is not always transmitted. The risk of infection is high, but a low percentage of the virus will definitely not lead to infection. As well as through biological fluid or tears with blood particles, it is impossible to get infected.
By law, infected people do not have any restrictions on work. A person, if desired, has the right to work in almost any place, wherever he wishes. Unless, of course, due to health reasons, they are able to cope with their labor obligations. The worker is not dangerous to society and carries absolutely no threat. In the case of illegal dismissal, the employer can always defend his rights in court. HIV and any work are not limited by anything. It can also choose any job for itself, along with everyone else, go on sick leave, work full-time or transfer to an easier job if the state of health requires it. Positive citizens can get any job, unless, of course, this is contrary to the legislation of the Russian Federation, which clearly indicates the list of professions for which sick citizens are admitted only if they have a health book. In particular, the employer also does not have the right to dismiss an employee or refuse him a job just because of HIV infection.
What does the law say?
The law outlines specific types of professions approved by the government of the Russian Federation, when it is required to inform the employer about their HIV status, undergo testing and medical. examination at the time of employment. There is a list of professions that require periodic checks by honey. personnel.
If problems arise with employment, citizens can file a lawsuit in accordance with the Constitution of the Russian Federation, where they can defend their rights. The law (Article 17) does not impose special restrictions on ore for HIV-infected people, who are now free in their choice. Moreover, they are not required to report their status to employers, just as they, in turn, do not have the right to ask if the position is not related to blood and quite allows this to be done. The only thing that should be done with an HIV positive status is to undergo a medical examination and tests, and only people of those professions, the list is approved by the Moscow government.
A number of professions where it is not allowed to work for HIV-infected people is narrow. These include:
- doctors, nurses;
- employees of transfusion and blood sampling stations;
- scientists whose work is directly related to the manufacture and development of immune drugs.
These people must undergo an annual medical examination to determine their HIV status and are subject to testing. Such professions are provided by federal law as closed.
For nurses, nannies, police officers, employees of general educational institutions, a positive HIV status cannot be a reason for refusing employment. With such an argument on the part of the employer, it is only worth reminding him of the list of closed professions, clearly and in detail prescribed in the federal law. By the way, even surgeons are not among the closed professions either.
To have a dignity in order. the book should be people whose work is directly related to products: cooks, confectioners, salespeople, bartenders in public catering. In addition, officially confirm your status at the initial stage. Yes, everyone who sells or produces food products should have a honey book, but of course, we are not talking about directly infecting another person. There is practically no risk of possible infection.
Despite various clarifications about the transmission of the AIDS virus, people are still wary of workers who are directly associated with the products. It is worth noting once again that HIV-infected people can work in catering and retail outlets, unless this poses a threat to their health when working in conditions with sudden temperature changes, in hot smoky workshops.
Myths about caregivers
Often, parents categorically refuse to send their children to kindergartens when they find out about the HIV-positive status of one of the caregivers or the child. Obviously, the immunodeficiency virus does not live in the environment for a long time, thus it does not pose any danger or threat to healthy people. The infection is not transmitted through handshakes, toys, shared items, and even saliva. The myth is when a caregiver with HIV positive status is denied employment.
Another thing is when infection through non-sterile needles is possible when giving an injection to children, but today such cases are rare. SES bodies carefully monitor the work of honey. staff at DOW.
Infection can occur in children with:
- performing an operation to remove appendicitis;
- transfusion of infected donor blood;
- breastfeeding by an infected mother.
It is still important for adults to understand that children are not contagious and can attend children. kindergartens, while having the right not to report their HIV status. During communication, the infection is not transmitted. As well as the kindergarten teacher is not a distributor of infection and is not contagious to others. HIV is not transmitted by household means and directors of institutions do not have the right to refuse an infected employee when hiring.
Admission of a child with HIV to a preschool educational institution is carried out on a general basis. The Government of the Russian Federation has determined the procedure for educating children with HIV and disabled people at home, paying the required compensation for the costs associated with education. Any discrimination of these people in society is excluded. Often, parents motivate by the fact that children in the nursery bite, play pranks, can inadvertently injure each other, thereby becoming infected through the blood. The likelihood of HIV transmission in such cases is negligible. It should be understood that even if the virus enters the wound, HIV transmission is unlikely and such cases have not yet been recorded. Most likely, infection will not occur if blood particles are left under the nails when children scratch. Theoretically, blood particles from under the nails can enter the mouth of a healthy child, but for infection to occur, the blood must enter directly into the blood. That is why the blood of an HIV-positive child does not pose any danger to healthy children. As well as infected teachers have the right to work in kindergartens or schools.
People are distrustful of employees of hospitals, clinics, family houses, dental centers, blood transfusion institutions, and beauty salons. Of course, infection in any of these social spheres is theoretically possible.
Annual HIV testing must be completed each year by:
- donors;
- employees of junior medical personnel of all specialized healthcare structures;
- scientists;
- employees of blood transfusion stations;
- specialists of research institutions for the production of immunological material;
- stateless citizens and foreign residents residing on the territory of the Russian Federation for more than 3 months.
Today, the circle of people subject to annual HIV testing has been expanded. Doctors, nurses, laboratory assistants, cleaners, hairdressers, employees of manicure and pedicure salons must pass. When an HIV diagnosis is made, the patient will be registered. In order to avoid the spread of the immunodeficiency virus throughout Russia, the legislation clearly spells out the list of workers subject to mandatory examination. Those. all those persons who directly deal with blood, biomaterials, preparations containing blood.
The law protects the interests of employees infected with HIV. There are large compensations in case of accidental infection at work, as well as benefits when working with increased contingency for possible infection with this virus.
The law does not stipulate the list of HIV-infected employees who can be fired. The interests of an employee in a hazardous production are under the personal protection of the state. The employer does not have the right to dismiss an employee, citing this as a source of infection. He can only offer a different job, where any contacts with healthy people will be excluded, as well as the risks of infection will be reduced to zero. In addition, when applying for a job, the employer does not have the right to demand even a certificate of passing the examination. A person does not have the right to disclose his status. Report it or not, this is a personal HIV infection. The law defines the circle of employees who are not subject to mandatory HIV testing and even at the request of the employer cannot be fired if HIV status is accidentally detected as immunodeficiency. It's just illegal. All rights and freedoms of citizens of the Russian Federation are protected by law.
Patients can only be limited in work due to possible infection with an infection or transferred to another position, where the ways of infection are excluded. The employer must notify each employee of vacant vacancies without exception.
It is possible to request a sanitary book for a circle of people involved in food or blood, but there can be no dismissal without any reason.
Today, in society, the perception of HIV is ambiguous. Not everyone correctly perceives the legislative wording in relation to such patients. Uncertainty and inconsistency of actions on the part of management when faced with HIV-infected employees can be traced everywhere. One thing should be clear, that a sick person cannot be fired just because of their HIV positive status. Of course, it provides for the delivery of tests and examinations when applying for a job, as well as for all those working in production as a planned annual honey. inspection. This is only necessary to monitor the health status of working personnel and the possible transfer to easier work when identifying one or another prof. diseases.
In almost all cases, HIV status is not a reason for dismissal. The main thing is that the work for such people should be commensurate with the permissible workload in production. Today, many entrepreneurs offer alternative employment options for HIV patients. These are remote vacancies by freelancers, journalists, programmers. Go retraining and retraining through the Internet is not difficult.
People with a positive HIV status often get sick and are on sick leave for a long time due to health reasons. This, of course, is not to the liking of many employers, but even in such cases, dismissal is illegal. The sick leave will be extended and, of course, paid until the patient completes the full treatment course. It is illegal to dismiss an employee even when opening a sick leave for more than 3 months. This is not a reason to get fired. It happens that the management puts an ultimatum: going to work or being fired. HIV-infected people should be aware of their rights. In case of discrimination, go to court, and upon receipt of disability, count on the prescribed benefits upon disability after passing the ITU. Dismissal of one's own free will is also possible, while the manager will be required to pay severance pay and average earnings for 2 weeks. In general, everything is as it should be for all healthy people when applying for a job or dismissal.
In Russia, for the period up to 2020 and beyond, a state strategy has been approved to combat the spread of HIV infection. The situation with the incidence of HIV infections is disappointing. Since 2006, there has been an annual increase in the number of new HIV infections, an average of 10% per year. In 2015, 28.3 million citizens of the Russian Federation and about 2 million foreigners underwent a medical examination for HIV infection. In 2015, the number of HIV cases detected among foreign citizens doubled compared to 2013.
To date, the passage of a medical examination by the population to detect HIV infection is an insufficient measure to prevent the spread of this disease.
What is HIV infection and how is it transmitted? HIV is the human immunodeficiency virus. Immunodeficiency is a condition in which the body cannot resist various infections. Most HIV transmission occurs:
- with unprotected sexual intercourse;
- when the blood of an HIV-infected or AIDS patient enters the body of a healthy person (when transfusing blood or its products from HIV-infected donors; when using non-sterile, untreated medical instruments containing blood particles of infected people)
- from an HIV-infected or AIDS-infected mother to a child.
What law governs the procedure for preventing the spread of HIV infection? This is Federal Law No. 38-FZ of March 30, 1995 "On Preventing the Spread of Disease Caused by the Human Immunodeficiency Virus (HIV) in the Russian Federation." Medical personnel have the highest occupational risk of HIV infection. When working with patients, conducting laboratory studies of biomaterials, it is necessary to strictly comply with the requirements of labor protection. Medical staff should always remember the basic principle of epidemiological precaution: any patient is considered as a potential source of infection. At the workplace of a medical worker, it is necessary to have an ANTI-AIDS first aid kit. It is designed to prevent and prevent HIV infection. The recommended composition of the first aid kit includes disinfectants, treatment of wounds, cuts, material for dressings. It should be noted that the obligatory presence of such a first-aid kit is also expected in consumer service organizations. For example, in hairdressing and cosmetology centers (clause 9.30 SanPiN 2.1.2.2631-10).
Also, to prevent infection, personnel should use personal protective equipment - rubber gloves. In addition, antiseptic dispensers should be located in intensive care units (clause 12.8
