December 1, 2022 is the 35th “World AIDS Day”. In order to further promote the high-quality development of AIDS prevention and control work in the new era, and comprehensively create a good atmosphere for the whole society to participate in AIDS prevention and control work, combined with the promotional theme “Equalize” of the 2022 World AIDS Day determined by UNAIDS, the Office of the State Council AIDS Prevention and Control Work Committee decided And announced that the theme of our country’s publicity activities this year is “To fight AIDS and share health”.
Medical and health personnel and the people’s police, etc. due to their occupations, contact with the The frequency of disease factors is higher than that of the general population. Therefore, there are relatively many opportunities for occupational exposure. Once occupational exposure to HIV occurs, timely and accurate treatment is very important. The earlier the treatment, the better the effect of prevention.
1. How to carry out local emergency treatment after occupational exposure?
After occupational exposure occurs, local emergency treatment should be carried out in time, and the employer should be reported within 1 hour. The employer shall report to the disposal agency within its jurisdiction within 2 hours after the exposure occurs, and provide relevant materials to cooperate with the disposal work.
Methods for local treatment of needle stick injury: Squeeze from the proximal end to the distal end, squeeze out as much blood as possible from the injured area, rinse thoroughly with soap and running water , It is forbidden to squeeze and suck the wound locally, and then disinfect it with iodophor, and bandage it if necessary (squeeze once, flush twice and disinfect three times).
Second, what happens after occupational exposure implement preventive medication?
The Center for Disease Control and Prevention in the area where it is located should evaluate and determine the level of exposure and the viral load level of the source of exposure. Blood samples should be collected within 24 hours of exposure, and preventive drug regimens should be implemented for medical personnel who have occupational exposure to HIV according to the exposure level and the viral load level of the source of exposure.
The preventive medication program is divided into basic medication program and intensive medication program. The basic medication program is two kinds of reverse transcriptase preparations, using conventional therapeutic doses, for 28 consecutive days. The intensive medication program is based on the basic medication program, and at the same time, a protease inhibitor is added, and the conventional therapeutic dose is used for 28 consecutive days.
Prophylaxis should be started as soon as possible after occupational HIV exposure, preferably within 4 hours implementation, no later than 24 hours; even if it exceeds 24 hours, preventive use should be implementedmedicine.
3. Follow-up and psychological counseling after occupational exposure
Occupational exposure to HIV among medical staff Afterwards, medical and health institutions should provide follow-up visits and consultation. The content of follow-up visits and counseling includes: HIV antibody detection at the 4th week, 8th week, 12th week and 6 months after exposure, monitoring and treatment of drug toxicity, observation and recording of HIV infection early symptoms, etc.
Occupational HIV exposure to medical and health personnel and the people’s police may cause great psychological pressure. We should give more psychological care, counseling, and help to guide They deal with stress events correctly, maintain an optimistic and healthy attitude, fully embody humanistic care in terms of physical and mental health, and minimize the physical and mental damage of medical staff.
【Author of this issue】
Zang Zhou, Institute of STD and AIDS Prevention, Shenyang Center for Disease Control and Prevention, is engaged in the treatment and management of HIV-infected and patients, occupational exposure management, and hepatitis C epidemic monitoring and management.