HIV transmission: guidelines for assessing risk - Canadian AIDS ...

HIV TRANSMISSION: Guidelines for Assessing Riskmay have been donated in the four-to-six-week windowperiod prior to the donor developing HIV antibodies.However, it cannot realistically be assigned a risk categoryunder this model. To further reduce this small risk, new andmore sensitive screening tests are being developed.Part 6. OtherBranding and ScarificationBranding and scarification are practices that can occur indifferent contexts, including in S/M activities or as part ofcultural practices, such as healing scarification.Potential for TransmissionHeat-branding does not meet the conditions for HIV transmissionbecause of the high temperatures involved (heatkills HIV). Knife-branding should only be done with asterile scalpel with a disposable blade (scalpels can be boughtat medical supply stores). It should only be used once, thenplaced in a strong narrow-necked plastic container with alid, and thrown in the garbage. If using a new scalpel is notpossible, the knife should be soaked in bleach for twentyminutes and then rinsed with water.Likewise, scarification should be performed using newneedles, knives or razors. If using a new equipment is notpossible, the equipment should be soaked in bleach fortwenty minutes and then rinsed with water.Evidence of TransmissionThere is a risk of HIV transmission from sharing unsterilizedbranding or scarification equipment under certaincircumstances, although there is little documented researchexploring the role of branding or scarification in HIV transmission27 , and none that demonstrate documented cases ofHIV transmission occurring through these practices. Thelack of literature mentioning this specific mode of transmissionmay not be conclusive.lack of mention in research literature precludes making arisk assignment.EstheticsPotential for TransmisisonEven without sterilization, it is unlikely that HIV wouldbe transmitted via manicures or pedicures as HIV does notsurvive long when exposed to the environment.Evidence of TransmissionThere is no evidence to support transmission occurringthrough receiving a manicure, pedicure, haircut, massage,etc.Assessment of Risk of HIV TransmissionManicures or pedicures with uncleanedequipment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .No RiskManicures or pedicures with sterilizedequipment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .No RiskFightingPotential for TransmissionMost of the conditions for transmission of HIV are presentin the case of a fight where both people have open cutsor wounds. However, due to the short life of HIV whenexposed to the open air, there is a question as to whether ornot there would be a sufficient level of the virus to transmitHIV.Evidence of TransmissionThere are no documented cases of transmission of HIV inthis manner.Assessment of Risk of HIV TransmissionFighting . . . . . . . . . . . . . . . . . . . . . . . . . Negligible RiskAssessment of Risk of HIV TransmissionAccording to our model, the lack of documented cases inrelation to the high potential of risk would lead this activityto be categorized as Negligible Risk. In this case though,the potential for risk associated with the activity and the27. Orubuloye, I. O. and Caldwell, Pat and Caldwell, John. A note on suspect practices during the AIDS epidemic: vaginal drying andscarification in southwest Nigeria. Health Transition Review, 5(suppl.):161-165. c. 1995.HIV Transmission33