The risk of blood exposure incidents in dental practices in the Netherlands.

OBJECTIVES: An awareness of the risk of blood-borne infections among dentists has been promoted by the Dutch Dental Association (NMT) as part of their quality and safety programme, and a nationally operating expert counselling centre was contracted to manage all reported incidents. METHODS: We analysed data on hepatitis B vaccination status, sex and age for all reported incidents recorded by this centre during 2008. We compared this with data collected at same time during a national survey to assess the performance of the centre. The number of blood exposure injuries among dentists and their assistants, and reporting behaviour, were also assessed. RESULTS: In 2008, 387 incidents were reported to the counselling centre. The percentage of high-risk incidents was 16, with a risk of hepatitis B, hepatitis C and HIV infections. In the hepatitis B cases, 12% had no or insufficient immunization. Eight per cent of those injured were unable to start HIV Post-Exposition Prophylaxis because they reported too late. Of the 1442 surveys sent, 487 (34%) were returned. Dentists estimated levels of hepatitis B vaccination at 98%. Thirty-two per cent reported to have had one or more injuries in their practice in 2008. Of these, 37% were counselled by the expert centre, 18% were counselled by others and 45% sought no medical attention. The performance of the counselling centre received a positive score (95%). A need for more information about vaccination and blood-borne infections in dentistry (52%) was reported. CONCLUSIONS: Nationwide data show blood exposure incidents occur frequently in dental settings, with a considerable number of high-risk incidents. Administering anaesthetics and cleaning-up are major risk factors. There is a need to intensify measures for safe working conditions in dental care settings in the Netherlands, irrespective of the type of dental practice.

Fear of Stigmatization as Barrier To Voluntary HIV Counselling and Testing In South Africa

Objective: The objective of this qualitative study was to identify psychosocial correlates of HIV voluntary counselling and testing (VCT); with an emphasis on the association between fear of AIDS-related stigma and willingness to have an HIV test. Methods: The study was executed in Limpopo Province at University of Limpopo; Polokwane; South Africa. Focus group interviews were held among 72 students; divided over 10 groups. Results: Results showed that participants had different levels of knowledge about HIV/AIDS and VCT; and that AIDS was still strongly associated with 'death'. Results further demonstrate that HIV/ AIDS related stigma is still a very serious problem in South Africa. Lack of HIV/ AIDS related knowledge; blaming persons with HIV/AIDS for their infection; and the life-threatening character of the disease were seen as the most important determinants of AIDS-related stigma. The main benefit to go for VCT was 'knowing your HIV status'; whereas main barriers for testing were 'fear of being stigmatised' and `fear of knowing your HIV positive status'. Conclusion: Fear of stigmatization is an important barrier to HIV testing and has negative consequences for AIDS prevention and treatment. Interventions to reduce HIV-related stigma are needed in order to foster voluntary HIV counselling and testing in South Africa