Basic measures to protect UK med students from HIV whilst working abroad

Around 3,000 British medical students opt to spend a year working abroad in a resource-limited setting. Last November, the British Medical Journal published the results of a survey of British medical schools which found that most medical schools had updated their policies to minimise the risk to which their students were exposed to HIV whilst on an elective in a resource-limited setting. Medical schools now advise students to take HIV post-exposure starter packs, to restrict periods of attachment in areas with a high prevalence of HIV, and not to undertake risk procedures in patients from such areas.

The survey was reported at aidsmap.com last November - the news story can be read

here.

A letter, published today in the British Medical Journal revisits this issue and discusses the need for all institutions that take elective students to develop effective and practical policies that minimise risk, whilst maximising experience, particularly when students are required to pay fees during their attachments.

Using South Africa as an example of a country with a high background HIV prevalence rate and one which is a popular destination for British medical student going abroad to work, the authors describe how measures have been put in place to reduce the risk and possible HIV infection.

All foreign students spending their elective in the trauma unit at Johannesburg General Hospital are required to undergo induction in preventing and managing needlestick injuries. No student is allowed to participate in any trauma resuscitation or open surgical procedure without full universal barrier precautions and specific protocols have been laid down about the handling of sharps.

Weekly video audit of trauma resuscitation is used to identify violations of the protocol and immediate post-exposure prophylaxis is available 24 hours a day along with counseling from an HIV specialist nurse.

The authors consider these measures to be a minimum for any institution hosting elective medical students, regardless of the background HIV prevalence rate.