Prevention of HIV infection

1. Counselling the person at risk re 'safer practices'

No effective vaccine has been developed. Modification of behaviour is the only valid strategy for prevention of HIV infection. Education programs to encourage sexual practices that reduce the exchange of genital secretions (safe sex) may achieve risk reduction for sexually active individuals. Condoms provide a barrier if used properly and consistently but may be too easily damaged to offer reliable protection during anal intercourse. A water-based lubricant such as KY gel or Lubafax should be used: oilbased lubricants such as Vaseline weaken condoms.

Discuss alternative sex practices including touching, cuddling, body-to-body rubbing and mutual masturbation.

Emphasise the importance of being in control with drug taking, IV usage, safe sex practices and the needle-exchange program.

2. Health professionals

Care should be exercised whenever blood samples are taken or sharps have been used. Advise safe disposal of sharps and other disposables and appropriate sterilisation of material. Gloves should be worn for all invasive procedures. Management of needle-stick injuries and other at-risk exposures is described in Chapter 116 .

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