Bloodborne HIV: Don't Get Stuck!

United Press International’s health section has an article about the possibility that salons providing manicures, pedicures, shaving and other services may not be taking adequate precautions to avoid transmitting hepatitis to their clients. The report finds that “barbershop nail files, brushes, finger bowls, foot basins, buffers, razors, clippers and scissors may transmit hepatitis”. That’s no surprise here on the Don’t Get Stuck blog, but it’s not often you’ll find it mentioned in a health department report.

Hepatitis B or C may be transmitted through these reusable instruments unless they are properly cleaned and disinfected. A commentator concludes that “The risk of transmission of infectious disease, particularly hepatitis B and C, in personal care settings is significantly understudied in the United States [my emphasis].”

That’s all very well for the US and other Western countries, where disinfection procedures are more widely known and there are enforceable regulations in place. But in resource poor countries, such as Tanzania, Kenya and Uganda, manicures, pedicures and other cosmetic procedures often take place in the open air, in shops, homes and offices, and they are carried out by people with little or no training.

Not only are these risks not studied but they are considered to be negligible by those tasked with reducing transmission of HIV and other blood borne viruses. In the absence of any investigation whatsoever, it is concluded that almost all HIV transmission in African countries results from ‘unsafe’ heterosexual behavior. In addition to being incorrect, this is highly stigmatizing.

Risks faced in health facilities are also denied by UNAIDS, WHO and the like.  There’s an article on HealthLeaders Media site about cancer patients in a Nebraska, US clinic who are infected with hepatitis C because a nurse changed a needle when moving on to another patient, but reused the syringe. Some healthcare professionals seem to think that carries no risk of transmission, but they are wrong. Almost 100 patients were found to be infected after a thorough investigation, involving the recall of thousands of patients.

Despite the investigation, CDC (US Centers for Disease Control and Prevention) say this and other similar incidents are just the tip of the iceberg; the entire might of the US public health sector doesn’t appear to know the full extent of the problem. Instances of reused syringes, reused saline bags and other devices were recorded. But outside of these investigations, most of those infected by such incidents tend to be discovered by accident.

The risk of infection with hepatitis, HIV and other blood borne viruses from healthcare and cosmetic services may seem small, but it’s still a risk, especially in countries where prevalence of blood borne diseases is very high. There is no excuse for assuming that a very small percentage of these services are likely to transmit diseases and that, therefore, the majority of HIV infections are from unsafe sex.

People availing of the services and people providing the services need to be aware of the risks and what steps they take to can avoid them. Healthcare and cosmetic service transmission of blood borne diseases in African countries is in urgent need of investigation.