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Dellinger, J. and Wild, C. (2012): Universal HIV-Testing. International Recommendations and actual risk of HIV-Infections for Healthcare-Workers. Decision Support Document 61.

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Abstract

Austria has the highest HIV-test rate per 1,000 inhabitants in the European Union: 99 tests per 1,000 inhabitants compared to the EU-average of 45.3 in 2010. This may be related to beliefs held by the health care personnel that knowledge of the HIV-status of a patient (e.g. via routine pre-operative testing) serves as a protective measure against occupational transmission of HIV.

In order to identify national and international guidelines on universal HIV-testing as well as literature on the actual infection risks for health care personnel, websites and databases were hand-searched. Additionally, statistical materials as well as information gained by interviews and inquiries were collected to depict the Austrian situation.

International guidelines tend to recommend universal screening for HIV in all health-care settings only when the undiagnosed prevalence of HIV is >0.1% or the diagnosed prevalence is >0.2%. Pre-operative screening is either not mentioned or explicitly not recommended.

HIV poses a small but real risk to health-care personnel. Since the beginning of counting until 2002, 106 cases of occupational HIV-infections have been documented worldwide: in Austria there have been 4 cases of occupational HIV-infection between 1996 and 2011. There is no convincing evidence that knowledge of the serostatus of a patient leads to changes in the behaviour of health-care workers. Fears of the health care personnel have to be taken seriously, but met with information on the actual magnitude and the real risk of occupational HIV-transmission. Information based on worldwide, European and Austrian data may be complemented by the analysis of hospital-specific laboratory-data from local patients. With an HIV-prevalence of about 0.1%, Austria is considered to be a low-prevalence country. Based on international guidelines, universal HIV-testing is not advisable in Austria.

Item Type:Decision Support Document
Keywords:HIV/AIDS, HIV-test strategy, occupational HIV-infection, pre-operative diagnostics
Subjects:WA Public health > WA 525-590 Health administration and organisation
WB Practice of medicine > WB 141-293 Diagnosis
QW Microbiology. Immunology > QW 501-949 Immunology
WA Public health > WA 400-495 Occupational medicine, health and hygiene
Language:German
Series Name:Decision Support Document 61
Deposited on:05 Oct 2012 12:28
Last Modified:12 Oct 2012 11:51

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