.. dical history-taking, questionnaires and donor inter- views. Very few people at risk of AIDS now come to give blood. The “self- elimination form”, filled out in a private booth, allows any who feel compelled by peer pressure to donate blood, total privacy to check the box that says “Do not use my blood for transfusion.” As to banking one’s own blood, or autologous donations, the Red Cross permits a few “medically suitable” people, referred by their physician, to store their blood if they are likely to need blood transfusion in upcoming elective surgery. They can bank up to four units of blood, taken in the five weeks before surgery.
Finally – it can be categorically stated – IT IS ABSOLUTELY IMPOSSIBLE TO GET AIDS BY GIVING BLOOD!!! Minimal risk to health care workers: While health care personnel face a slight risk of HIV infection, all cases reported to date have been due to potentially avoidable mishaps or failure to follow recommended precautions. Of thousands caring for AIDS patients worldwide, only a tiny percentage has become infected, and so far no Canadian health personnel have become HIV-infected. A survey done by the Federal Centre for AIDS (FCA) of 50 workers occupationally exposed to AIDS showed that none became infected. A british hospital study on staff looking after 400 AIDS patients over several years found none who became HIV-positive. In one U.S. survey, 7 out of 2,500 health care workers seroconverted and developed HIV antibodies all by potentially avoidable accidents such as needle pricks, exposure to large amounts of blood, body fluids spattered into unprotected mouth, eyes or open sores.
The reported mishaps underscore the need for rigorous, vigilant compliance with preventive guidelines. Universal body substance precautions (BSP) urged: The newest guidelines suggest that every health care worker, including dentists, should handle all blood and body fluids as if infectious. Testing all patients for HIV is not practical and does not confer protection. Rely-ing on tests that are not 100 per cent accurate would only induce a false sense of security. Rather than trying to identify infected persons, the CDC and Ottawa’s FCA now promote a philosophy that regards all patients as potentially infected.
(At Johns Hopkins in Baltimore, about six percent of admissions to the Traumatic Emergency Unit recently tested HIV-positive.) Hospital and health care workers (including those caring for patients at home) are encouraged to”think AIDS” and protect themselves. All patients should be handled in a way that minimizes exposure to blood and body fluids, e.g. by always wearing gloves when touching open sores, mucous membranes, taking blood, attending emergencies, putting in IV needles, touching blood- soiled items, with scrupulous hand-washing between patients (and whenever gloves are removed), wearing masks, eye protection, plastic aprons and gowns when appropriate. Taking such precautions will not only protect against AIDS but also against more infectious agents such as hepatitis B and some hospital acquired infections. We are all being forced to remember stringent anti- infection rules! Absolutely no evidence of spread by casual contact: All the research to date points to the fact that AIDS is not very easy to catch.
One University of Toronto microbiologist speculates that those with high antibody counts are probably not very infectious. The most infectious appear to be seemingly healthy persons carrying HIV without any sign of disease as yet. AIDS CANNOT BE PICKED UP CASUALLY via doorknobs, public washrooms, shared school books, communion coups, cutlery or even by food handlers with open cuts. A relatively weak virus, HIV is easily killed by a dilute 1 in 10 solution of Javex/bleach, rubbing alcohol and other disinfectants. Even where parents or caregivers have cleaned up HIV-infected blood, vomit or feces, HIV has not been transmitted.
It is perfectly safe to share a kitchen, bathroom, schoolroom or workbench with HIV-infected individuals. But it is inadvisable to share toothbrushes, razors, acupuncture needles, enema equip- ment or sharp gadgets, which could carry infected blood through the skin. ORDINARY, NONSEXUAL WORKPLACE AND CHILDHOOD ACTIVITIES DON’T TRANSMIT AIDS. The rare exception might be direct blood-to-blood contact via cuts or wounds if infected blood (in considerable amounts) spills onto an open sore. Even in such cases a swab with dilute bleach can kill HIV viruses.
Not spread by mosquitoes and other insects: There’s no evidence of HIV transmission by insects. Researchers report that the AIDS virus cannot multiply or survive inside a mosquito. The infection pattern in Africa – where children who are not sexually active might be expected to have AIDS if mosquito bites were a real threat – shows no sign of insect transmission. Vaccines still a way off: Scientists caution that a safe, effective vaccine against HIV may be at least a decade away, mainly because, like the influenza virus, HIV mutates (changes structure) quickly, producing different strains. (Several different HIV strains have already been isolated.) An ideal vaccine must be able to stimulate neutralization of both “free” viruses and those hidden within lymphocytes, such as T-helper cells. Researchers in various countries have developed and are testing a few preliminary vaccines.
One sub-unit vaccine, made from virus coat material (a glycoprotein) genetically cloned in an insect virus (the baculovirus, which attacks moths and butterflies but no humans) has been shown to stimulate an immune response in experimental animals. Another preliminary vaccine, produced by cloning modified Vaccinia viruses, containing a portion of HIV envelope, is about to enter clinical trials in New York. (It would be applies, like the old smallpox vaccine, into a small scratch.) But to date no vaccine tried in animals or humans has been shown to prevent AIDS. Testing no solution: Large scale, screening of the public for HIV antibodies offers little pro- tection because today’s apparent negatives can become infected tomorrow or test seropositive when antibodies develop in those already harboring HIV. Reliance on tests could lull people into false complacency. A “false nega- tive” result may fool someone into risky sexual behaviour. Curiously, despite a widespread demand for tests, especially among high-risk groups, a study in Pittsburgh showed that 46 percent of a group of homosexual/bisexual men tested did not return for or want their antibody test results.
Many health experts therefore believe that mandatory testing would be useless as HIV antibody tests only indicate exposure, not necessarily infectivity. As one University of Toronto virologist puts it: “Widescale compulsory screening for HIV antibodies is not necessarily useful and will do nothing to promote prevention or cure. What’s needed perhaps is more accurate knowledge about the disease and more responsible behaviour rather than testing.” Those who should consider testing might include people known to be at high risk and any who think they may have been HIV-infected or who wish to be tested and have discussed it with their physician. What’s needed, as with any infectious disease, is not more testing buy more precautions against infection. Message clear but still largely unheeded: Despite a veritable blitz of AIDS information, experts claim that too few people are changing their lifestyles or behaviour sufficiently to protect themselves from AIDS. A recent Canadian poll revealed widespread ignorance of the fact that AIDS is primarily a sexually acquired infection, not caught by casual touch. The survey showed that although sexual intercourse among adolescents has risen steeply in the past 10 years, less than 25 percent of those aged 18 to 34 have altered their sexual behaviour to protect them- selves against AIDS, i.e.
by consistent use of condoms and spermicide. THE CENTRAL MESSAGE IS CLEAR: UNLESS ABSOLUTELY SURE (and monogamy is no guarantee) THAT YOUR SEX PARTNER IS HIV-FREE, USE A CONDOM (latex, not made of animal material) plus a reliable spermicide (e.g. one containing nonoxyl- 9). Studies with infected haemophiliacs show that condom use by a regular sex partner reduces infection risks, compared to unprotected sex. And regular condom use may bring the added reward of preventing other sexually trans- mitted diseases such as gonorrhea and chlamydia or unwanted pregnancy.
Many educators say that, by whatever means, AIDS information must get out to young people at an early enough age for them to absorb it before becoming sexually active. Only by acting upon accurate AIDS information can people protect themselves, their sex partners, families and ultimately society from this disease. Protection the only answer: The best way to avoid AIDS is to regard it as a highly lethal disease and practice commonsense prevention. Avoiding infection is IN ONE’S OWN HANDS. People can protect themselves. To halt its spread, people are encouraged to obtain and apply accurate AIDS information to their living styles and sexual habits in order to reduce the risk of getting or transmitting the virus.
Sadly, health promoters claim that “reaching the many who don’t want to know” is no easy task. Health promoters suggest that educators must learn how and when to communicate AIDS information – in the right way at “teachable” moments. Many Public Health Departments are now taking the lead in disseminating education about AIDS with largescale public awareness programs. What of the future?: Many virologists believe that since antibiotics became available in the late 1940s we have become too complacent about viral infections, no longer take communicable disease seriously, and have modern medical schools which devote few teaching hours to anti-infective strategies. In fact, we still know little about retroviruses such as HIV. Perhaps special virology research centres, like the Virus Research Institute proposed for the University of Toronto, will help to halt the tragic toll of AIDS and other as yet unknown viruses waiting in the wings.
For more information on AIDS or aid for AIDS call: local AIDS committees, Public Health Departments, or AIDS Hotlines (in Toronto 392-AIDS.) In everyday conversations, AIDS is usually a source for humour. For anybody who is suffering from the disease there is very little humour. The best prevention is not the thought that “IT COULD NEVER HAPPEN TO ME”, if that was so all the insurance companies would be out of business. The most reliable person to be put in-charge of preventing you for getting AIDS is YOURSELF!!!!.