For. Correctional. Officers. Your. Health Risks. in Correctional Settings. Facts. About HIV

For Correctional Officers Your Health Risks in Correctional Settings Facts About HIV

Working in close quarters with inmates in a correctional facility puts correctional officers (COs) at increased risk for certain diseases such as TB, hepatitis, and HIV. This brochure focuses on HIV, the virus that causes AIDS. You probably know that the rate of HIV infection in US prisons is more than 6 times the rate nationwide. This crisis poses risks to those working in prisons, but they are manageable. As a CO, you are in a position to help control the epidemic as well as protect yourself from possible infection. But you need to know the facts about the risks of HIV transmission. Among the hard lessons the AIDS epidemic has taught us is that education is the most powerful weapon we have against HIV. This booklet presents information about your risk of infection and what you can do to protect yourself in case of exposure. The goal is to create a healthier workplace for you, which will translate into real health benefits for you and your family. What are HIVand AIDS? HIV (Human Immunodeficiency Virus) is the virus that causes AIDS. Over time, this virus destroys the immune system the body s main defense against infections. AIDS (Acquired Immune Deficiency Syndrome) develops after the immune system has been badly damaged by HIV, leaving the body open to life-threatening infections. A person with HIV may show no signs of the disease for 10 years or longer after infection. All the while, HIV is multiplying in the body and steadily doing damage. You cannot tell from someone s appearance if he or she has HIV. Some people look and feel healthy for many years before symptoms appear. However, such people can infect others, as discussed on the next page. The only way to know for sure if someone has HIV is by means of a blood test. HIV making copies of itself 2 3

How You Can Get HIV Infection can occur only when a person with HIV passes certain of his or her body fluids directly into another person s body, specifically: blood semen vaginal fluids HIV is not only a gay disease it can also occur between men and women. The main ways that HIV is passed from person to person are: sex without a condom sharing needles and syringes from mother to child (before or during birth, or through breast-feeding) How You Don t Get HIV There is no danger of infection from casual contact with people with HIV. HIV cannot enter your body through the skin unless it is broken or cut. There is no evidence that HIV is passed through saliva/spit, sweat, or tears. 1 You cannot get HIV through the air when someone coughs or sneezes. You cannot get HIV by touching or shaking hands with someone who is infected. You cannot get HIV by closed-mouth or social kissing. (Only one case of HIV infection caused by open French kissing has been reported to date.) 1 You cannot get HIV from a toilet seat, telephone, or water fountain, or by sharing someone s drinking glass, food plate, or eating utensils. 4 5

Your Risk for HIV Infection in Prison Blood or bloody fluids from someone known to be HIV positive (HIV+) is the primary source of HIV infection in prisons for COs. Your chances of exposure may be especially high when splashed with blood during a fight. Because you may not know if an inmate has HIV, see employee health services immediately. Your Risk Scale This risk scale assumes an inmate is HIV+ No risk Feces Contact with feces ( chunking or gassing ) carries no risk for HIV infection, but does carry risk for hepatitis and other infections. 2 Urine Contact with urine carries no risk for HIV infection. 2 Spitting Contact with saliva carries no risk Small risk Getting HIV from a human bite that does not break the skin is unlikely; the risk increases if the assailant has mouth sores or bleeding gums. 1,3 Blood splashing in your eyes, nose, or mouth carries little risk for HIV; however, the risk increases when there is a lot of blood. 1 Blood splashing on your chapped skin, skin abrasions, or open wounds poses low risk; however, the risk increases when there is a lot of blood over a large area of skin. 4 High risk Any slash or puncture wound from a knife, needle, glass, or other sharp object may put you at risk for HIV infection, especially when the instrument is visibly contaminated with blood. 4 Deep, skin-breaking bites from an inmate who has mouth sores or bleeding gums poses high risk. 4 Deep injury with a hollow-bore needle carries the highest risk for HIV transmission. 4 for HIV infection. 1 Vomit Contact with vomit unless it contains visible blood carries no risk for HIV infection. 2 6 7

Real-Life Situations On any given day, a situation may arise that places you at risk for infection. Here are two real-life situations: Small risk You re breaking up a fight between two inmates, and one of them bites you on your hand, slightly breaking the skin. You don t know whether the inmate has HIV, but you do know he is a former drug user. The doctor at employee health services confirms that HIV transmission from a bite wound is unlikely. However, he s worried that the inmate may be HIV+ because of his drug use. The doctor wants you to take an HIV test, with two follow-up tests 3 months apart to make sure. Until then, he advises you to always use a condom during sex to protect others from possible transmission. If you think you have been exposed to HIV even if you believe the risk is low go to employee health services immediately. High risk You notice an inmate sporting a fresh tattoo. Concerned that a hollow-bore needle is hidden in someone s cell, you immediately tell your supervisor. A shakedown is ordered. Although you are wearing gloves and being cautious during the search, you toss the mattress and feel a sharp jab in your hand. A dirty needle is stuck deeply into your palm. In this situation, your risk of infection is relatively high if the inmate involved is HIV+. In this case, the doctor at health services may offer you PEP an immediate course of HIV medicines that may keep you from getting infected with the virus (see next page). To be effective, PEP must be initiated as soon as possible ideally within 1 hour and no later than 1 week after exposure. 8 9

PEP: Protecting Yourself after Exposure to HIV Making Your Workplace Healthier PEP, short for Post-Exposure Prophylaxis, involves taking a course of HIV medicines for 28 days to prevent infection with HIV after you have been exposed in a high-risk situation (often a knife wound or needle stick from someone who is known to have HIV). If you can reduce the barriers to inmate HIV testing and medical treatment, you will make your working environment healthier. Although HIV medicines don t cure HIV, they do reduce the amount of virus in an infected person s blood and reduce the risk to other people like you. PEP is not a guarantee PEP isn t foolproof; however, medical experts estimate that PEP lowers the risk of getting HIV by 80% or more. 5 The sooner PEP is initiated, the lower the risk of infection. 4,5 If you think you have been exposed to HIV even if you believe the risk is low go to employee health services immediately. Drug side effects associated with PEP All HIV medicines have some side effects, most often at the beginning of therapy. These side effects usually are not serious, and your healthcare professional will tell you what to expect. HIV test If you would like more information about HIV education, testing, and treatment, call 1-888-825-5249. If you do experience side effects after starting PEP, contact health services immediately. 10 References: 1. Centers for Disease Control and Prevention. HIV and its transmission. Available at: ftp://ftp.cdcnpin.org/factsheets/trans.pdf. Accessed October 21, 1999. 2. American Red Cross. This month s HIV/AIDS facts. October 1998. Available at http://www.redcross.org/ tips/october/answer98.html. Accessed July 6, 1999. 3. Vidmar L, Poljak M, Jomazic J, Seme K, Klavs I. Transmission of HIV-1 by human bite. Lancet. 1996;347:1762. Letter. 4. AIDS Institute, New York State Department of Health. Criteria for the Medical Care of Adults With HIV Infection. Chapter 3. HIV prophylaxis following occupational exposure. June 1998. 5. Centers for Disease Control and Prevention. Public health guidelines for the management of health-care worker exposures to HIV and recommendations for postexposure prophylaxis. MMWR. 1998; 47(RR-7):1-29. 11