Risk Factors

  1. Risk Factors for HIV
    • Known Risk: AIDS/HIV infected patient
    • High Risk: Men who have had sex with men, users or past users of illicit parenteral drugs, hemophiliacs or persons with coagulation disorders who have received blood products, recipients of blood transfusions (1978-1985), prisoners, prostitutes, persons with a medical condition suggestive of AIDS or HIV infection; sexual partners or children of persons with AIDS/HIV infection or in any of above high risk groups.
    • Potential Risk: Person who has had a sexual partner whose history is unknown. Recipients of blood after 1985.
    • Low Risk: All other persons.
  2. Risk Factors for Hepatitis B
    • Known Risk: Hepatitis B (HBV) Carrier (HBsAg Positive)
    • High Risk: Residents of institutions for the mentally retarded or developmentally disabled, hemophiliacs or persons with coagulation disorders who have received blood products, history of hemodialysis, men who have had sex with men, users or past parental users of illicit drugs, prisoners, immigrants/refugees from areas of high HBV frequency (e.g., Asia, Africa), Alaskan natives/Pacific Islanders, sexual, household contacts, or children of HBV carriers.
    • Low Risk: All other persons.
  3. Risk Factors for Hepatitis C
    • Known risk: History of non-A, non-B hepatitis (parentally transmitted hepatitis C)
    • High Risk: Hemophiliacs or persons with coagulation disorders or who have received blood products, (particularly prior to 1990), injecting drug users, hemodialysis patients, heterosexuals with multiple sexual partners, homosexual men, sexual contacts of an HCV infected person.
    • Low Risk: All other persons.

During the ASM I, II course, students will be introduced to the principles of the epidemiology and control of the transmission of infections in hospitals. Emphasis will be placed on protecting both the patient and the health care worker from acquiring infections, while stressing that the central role of physicians-delivery of optimal medical and interpersonal care to patients-need not be compromised by considerations relating to infection control.

The task of health care workers regarding AIDS is to provide needed emotional support as well as medical care to patients at all stages of infection with the HIV virus. The risk of seroconversion from a needle stick without prophylaxis, with HIV-infected blood is estimated at 0.32 percent Although this is a small risk, concern over infection with the HIV through providing patient care is quite real and best dealt with by adhering to proper infection control procedures. The risk of acquiring Hepatitis B after a needle stick is much greater which is why vaccination is strongly recommended.

Standard precautions within the health care setting should be standard practice in order to reduce the incidence of exposure to infectious blood and body fluids. It is clear that the strict practice of safeguards to prevent accidental exposure will decrease their occurrence. Since inoculation with infected blood is the most frequent means of injury, all students must take precautions to prevent injuries caused by needles, scalpel blades, and other sharp instruments. To prevent needlestick injuries, needles should not be recapped, purposely bent or manipulated by hand. After they are used, disposable syringes and needles, scalpel blades, and other sharp items should be placed in puncture-resistant containers for disposal. Reusable needles should be left on the syringe body and should be placed in a puncture-resistant container for transport to the reprocessing area. All students will receive annual OSHA Infection Control training. In addition, all physicians licensed in the state of New York are required to attend an Infection Control training course every four years.

Despite all proper observance of precautions, accidental exposures to infectious agents, such as the Hepatitis B virus and the HIV virus, can occur. Pre-exposure vaccination with the Hepatitis B virus (HBV) vaccine, as well as post-exposure prophylaxis for hepatitis following an event, are incorporated as standard practices in the Infection Control Guidelines of the School of Medicine. All students receive free immunization at the Student Health Service. Hepatitis B vaccines provide over 90 percent protection against Hepatitis B for seven or more years post-vaccination. After exposure to HBV, a combination of Hepatitis B immunoglobulin and vaccine are effective in preventing Hepatitis B in over 90 percent of incidents.