AIDS: Acquired Immune Deficiency Syndrome, or AIDS, is a disease caused by infection with the Human Immunodeficiency Virus (HIV). The virus destroys the immune system leaving people with AIDS unable to fight off other diseases.

How AIDS is spread: AIDS is spread when HIV-infected blood, semen, vaginal/cervical fluids, or other body fluids that contain blood pass into another person's body. AIDS is most often spread through unprotected sexual activity with an infected person or by drug users who share contaminated needles.

Who is at risk: Health care and any other workers that are stuck by needles or cut with contaminated sharp devices, or have routine exposure to blood or body fluids.

Prevention: Using syringes and other sharps that are designed to prevent needlesticks and other injuries. Treating all blood and body fluids as infectious (universal precautions). Wearing gloves and other protective equipment to avoid contact with all blood and body fluids that may contain blood.

WHAT IS AIDS AND HIV?

Acquired Immune Deficiency Syndrome, or AIDS, is a disease that is caused by a virus. The virus that causes AIDS is Human Immune-deficiency Virus (HIV). HIV attacks the immune system, which is the body's natural defense against infections. People with AIDS become ill when the immune system is too weak (immunocompromised) to fight off other infections. More than 450,000 people with AIDS have died in the United States. The estimated number of people infected with HIV in the United States as of the end of 2000 is between 750,000 and one million.

WHAT ARE THE SYMPTOMS AND HEALTH EFFECTS?

"HIV-positive" refers to people that are infected with HIV. There are generally no symptoms of HIV infection. Once the immune system becomes damaged, the individual is likely to experience weight loss, persistent low-grade fever, night sweats and flu-like symptoms. As the individual's immune/defense system becomes less able to ward off diseases, the infected person will likely come down with pneumonias, intestinal disorders, and fungal infections. These so-called "opportunistic infections" can be treated with medication. An HIV-positive person is given a diagnosis of "AIDS" after developing an opportunistic infection.

HOW IS THE DISEASE SPREAD?

HIV is a bloodborne disease. This means that HIV lives in blood and it can also live in any body fluid that contains blood. These include semen from men, and all vaginal/cervical fluids from women. The virus is also found in internal body fluids that surround the heart, the lungs, and bone joints (like the shoulder and elbows), as well as spinal fluid. HIV is NOT normally found in urine, feces or saliva. However, because of injury or illness, some of these substances may be contaminated with blood.

HIV is spread when infected blood, semen, vaginal/cervical fluid or other infectious materials pass into another person's body. The virus is most often spread through unprotected sexual activity with an infected man or woman or by drug users sharing contaminated needles.

WHO IS AT RISK?

The workers with the greatest risk of becoming infected at work are those with jobs that involve routine exposure to blood and other body fluids. Health care and other workers can be exposed to HIV from needlesticks and cuts and nicks caused by sharp objects. Infection can also occur if workers have contact with blood or infectious body fluids through broken, cut or torn skin. There is a risk of infection if workers are splashed with blood or other body fluids that make contact with naturally wet skin in the eyes, nose, or mouth. Corrections staff, law enforcement, and public safety workers such as emergency medical personnel are at risk through exposure to blood or fluids infected with blood.

IS THERE A TEST TO KNOW IF A PERSON IS INFECTED?

The most common method to find infection is a blood test known as ELISA. A major problem with the ELISA test is that it can take several weeks or months after infection before the test can detect HIV infection. The period from when someone becomes infected and actually has a positive blood test (seroconversion) is called the "window period." During the window period a person will have a negative test result even though they have the virus and can infect others.

HOW CAN THE SPREAD OF HIV BE PREVENTED?

Preventing infection depends on avoiding contact with blood and other fluids that might contain HIV. "Universal precautions" (also known as "standard precautions") means treating everybody's blood and body fluids as if they were infected.

Needlesticks can be prevented by using needleless systems, retractable syringes and other devices that have built-in safety features. "Barrier protection" must be used to shield all naturally wet skin (mouth, nose, eyes, etc.) and all broken, cut or torn skin. The barrier must be leakproof so that infected blood or other fluids cannot pass through it. Latex rubber, other heavy rubbers, materials with certain types of vinyl, and other plastics are good barrier materials. Latex rubber gloves shield the hands by covering any tiny cuts, hangnails, and cracked dry skin that might provide an entry for the virus. Masks, goggles and face shields cover the naturally wet skin in the eyes, nose and mouth from splashes of blood or other infected materials.

WARNING: Many workers are allergic to latex and need to have gloves made of other materials that also provide effective barrier protection.

IS THERE A CURE OR TREATMENT FOR AIDS?

There is no vaccine to prevent HIV infection at this time. In the last several years there has been substantial progress using drugs to treat AIDS-related diseases. There are also medications that have been used to interfere with the HIV/AIDS virus itself. For some people, these medications can slow down the effects of the virus and allow the immune system to partially restore itself.

After an exposure to blood or other potentially infectious material, it is critical that the exposed worker be promptly evaluated by a competent medical professional. The United States Public Health Service issued treatment guidelines in 1998 for the prevention of HIV infection after exposure. The medications should be taken within 2 hours after an exposure.

WHAT LAWS EXIST TO PROTECT WORKERS FROM AIDS?

OSHA Bloodborne Pathogens Standard (29 CFR 1910.1030)

In 1986, AFSCME was the first union to request that the Occupational Safety and Health Administration (OSHA) issue a regulation to protect workers from occupational exposure to bloodborne diseases. OSHA issued the "Bloodborne Pathogens Standard" in 1991. The standard requires that employers:

• Have an exposure control plan to identify workers at risk.
• Provide safety needles and puncture proof containers for used sharps.
• Ensure that universal precautions are practiced.
• Provide gloves, masks, and other protective equipment.
• Provide prompt evaluation and treatment to workers who have a needlestick or other exposure to blood.
• Train workers each year on bloodborne diseases.

The Needlestick Safety and Prevention Act passed in 2000 amended the OSHA bloodborne pathogens standard to include stronger requirements to provide safety needles, more accurate recording of needlesticks, and involving workers in the selection of equipment and work practices to prevent needlesticks and other exposures to blood.

January 2001