HIV transmission can occur if the patient is infected with the virus. In this situation, testing for HIV antibody may be indicated. Any accidental, occupational injury of a health care worker that may have exposed the worker to HIV should be reported confidentially to the physician responsible for occupational employee health in the institution where the injury occurred or to a physician not involved in the injury or the care of the infected patient. The patient should be asked to undergo voluntary HIV antibody testing and to consent to communication of the results to the injured worker, unless it is already known that the patient is HIV positive. Such testing should always be accompanied by pretest and post-test counselling.
Compulsory testing is unjustified.
Counselling and voluntary HIV antibody testing should be made available to the injured health care worker. In general, the test results should be communicated to the worker, with confidentiality maintained. If both an infection-control group and an occupational health service exist in a health care institution the responsibilities of each with respect to the management and prevention of occupationally transmitted HIV infection should be defined and coordinated. Although the scientific evidence supporting prophylaxis is weak, health care workers exposed to HIV may wish to consider this option. Treating physicians should keep informed of developments in prophylaxis.