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Occupational Medicine Advance Access published online on July 14, 2008

Occupational Medicine, doi:10.1093/occmed/kqn083
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© The Author 2008. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Short Report

HIV post-exposure prophylaxis among police and corrections officers

Roland C. Merchant1,2, Jacob E. Nettleton3, Kenneth H. Mayer2,4 and Bruce M. Becker1,2

1 Department of Emergency Medicine, Warren Alpert Medical School, Brown University, Providence, RI, USA
2 Department of Community Health, Warren Alpert Medical School, Brown University, Providence, RI, USA
3 Brown University, Providence, RI, USA
4 Department of Medicine, Division of Infectious Diseases, Warren Alpert Medical School, Brown University, Providence, RI, USA

Background Police and correctional officers face the occupational hazard of blood and body fluid exposures, which carry the risk of infection with HIV.

Aims To estimate the incidence rate (IR) of emergency department (ED) visits for blood or body fluid exposures sustained by police and corrections officers in an entire state and to quantify the utilization of HIV post-exposure prophylaxis (PEP) in response to these exposures.

Methods A retrospective study of police and corrections officers presenting to EDs in Rhode Island between 1995 and 2001. The investigators estimated IRs of ED visits for these exposures with 95% confidence intervals and determined factors associated with HIV PEP using bivariate Pearson's {chi}2 analyses.

Results The average annual incidence of ED visits for blood or body fluid exposures over the study period was IR 4.41 (2.31–6.51) exposures per 1000 police and corrections personnel. Only 15% of officers sustained percutaneous injuries or blood-to-mucous membrane exposures. Sixteen officers were offered HIV PEP and 10 accepted it. Offering of HIV PEP was 3.3-fold greater for officers sustaining percutaneous and blood-to-mucous membrane exposures instead of other body fluid exposures.

Conclusion The incidence of ED visits for blood or body fluid exposures by police and corrections officers was low and most exposures did not have the potential for HIV transmission. HIV PEP was infrequently used for these exposures.

Keywords      Blood-borne pathogens; HIV; needlestick injuries; occupational exposure; police; post-exposure prophylaxis


Correspondence to: Roland C. Merchant, Department of Emergency Medicine, Rhode Island Hospital, 593 Eddy Street, Claverick Building, Providence, RI 02903, USA. Tel: +1 401 444 5109; fax: +1 401 444 4307; e-mail: rmerchant{at}lifespan.org


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