INFECTION-CONTROL PRACTICES IN THE HOME - A SURVEY OF HOUSEHOLDS OF HIV-INFECTED PERSONS WITH HEMOPHILIA

OBJECTIVE: To assess infection control practices and risk for human im munodeficiency virus (HIV) transmission in households where home infus ion for hemophilia is used. DESIGN: Cross-sectional prospective survey from 1992 through 1994. SETTING: Hemophilia treatment centers. PARTIC IPANTS: Human immunodeficiency virus (HIV)-infected persons with hemop hilia who receive home infusions of clotting factor concentrate and th eir household members. MAIN OUTCOME MEASURES: Frequency of specific in fection control practices in the home and the risk of HIV transmission to household members. RESULTS: We surveyed 235 persons from 75 famili es (79 HIV-infected persons with hemophilia and 156 household members) about infection control practices in the home. Forty-eight percent of household members surveyed helped with the infusion process. Of 74 me mbers who assisted with infusion, 13 (18%) had sustained a needlestick injury, 11 of whom were injured during the past year. One hundred fif ty household members tested for antibody to HIV were antibody negative . These household members had a total of 903 person-years of contact a fter HIV was diagnosed in the index case. Household members' adherence to recommended infection control measures was highest for washing han ds after cleaning up infusion equipment and waste, and for using sharp s disposal containers. Adherence was lowest for wearing gloves when he lping with infusions and proper disposal of bloody waste from the infu sion. CONCLUSIONS: No HIV transmission was found among persons living with HIV-infected persons with hemophilia, although there was a high r ate of needlestick injuries during home infusion. Because persons who assisted with infusions often did not wear gloves and many households did not dispose of bloody waste properly, hemophilia treatment center personnel should emphasize these areas when training for home infusion . Adherence to appropriate infection control practices should help to keep the risk of HIV transmission in households extremely low.