There is a small but definite risk to health care workers of acquiring HIV infection via needle stick exposures, large mucosal surface exposures, or exposure of open wounds to HIV-infected secretions or blood products. The risk of HIV transmission after a skin puncture by an object contaminated with blood from a person with documented HIV infection is ~0.3%, compared with a 20-30% risk for hepatitis B infection from a similar incident. Postexposure prophylaxis may be effective in decreasing the likelihood of acquisition of infection through accidental exposure in the health care setting. In this regard, a U.S. Public Health Service working group has recommended that chemoprophylaxis be given as soon as possible after occupational exposure. While the precise regimen remains a subject of debate, the U.S. Public Health Service guidelines recommend a combination of two nucleoside analogue reverse transcriptase inhibitors plus a third drug given for 4 weeks for high-risk or otherwise complicated exposures. Regardless of which regimen is used, treatment should be initiated as soon as possible after exposure and take into count any available resistance data on the infecting virus.

Prevention of exposure is the best strategy and includes following universal precautions and proper handling of needles and other potentially contaminated objects.

Transmission of TB is another potential risk for all health care workers, including those dealing with HIV-infected pts. All workers should know their PPD status, which should be checked yearly.