Screening surgeons for HIV infection: assessment of a potential public health program.


Journal Article

OBJECTIVE:To develop a model to assess the impact of a program of testing surgeons for human immunodeficiency virus (HIV) on the risk of HIV acquisition by their patients. DESIGN:A Monte Carlo simulation model of physician-to-patient transmission of human immunodeficiency virus (HIV) infection using three different rates of physician-to-patient transmission per percutaneous exposure event (0.15%, 0.3%, 0.6%). Data from the model were developed from a review of the medical literature and from subjective probability estimates when data were not available. We used this model to estimate on a national basis the annual number of cases of HIV transmission from surgeons to patients with and without surgeon testing and practice limitations. RESULTS:The annual number of transmitted cases would range from 0.5 (+/- 0.3), assuming a surgeon HIV prevalence of 0.1% and a surgeon-to-patient transmission rate of 0.15%, to 36.9 (+/- 11.6), assuming a surgeon HIV prevalence of 2% and a surgeon-to-patient transmission rate of 0.6%. After one screening cycle, a mandatory screening program would be expected to reduce the annual transmissions to 0.05 (+/- 0.03) and 3.1 (+/- 1.1), respectively. CONCLUSION:Patients are at low risk of acquiring HIV infection from an infected physician during an invasive procedure. The potential costs of such a program extended beyond the costs of testing and counseling. In communities with high HIV prevalence, screening surgeons and limiting their practices may decrease patient access to care. A disability insurance program also would be required to protect surgeons and trainees performing invasive procedures. Screening surgeons for HIV infection would be a costly undertaking that would reduce but not completely eliminate this risk.

Full Text

Cited Authors

  • Schulman, KA; McDonald, RC; Lynn, LA; Frank, I; Christakis, NA; Schwartz, JS

Published Date

  • March 1994

Published In

Volume / Issue

  • 15 / 3

Start / End Page

  • 147 - 155

PubMed ID

  • 8207171

Pubmed Central ID

  • 8207171

Electronic International Standard Serial Number (EISSN)

  • 1559-6834

International Standard Serial Number (ISSN)

  • 0899-823X

Digital Object Identifier (DOI)

  • 10.2307/30145553


  • eng