BCCO PCT #4 PowerPoint AND HIV/AIDS & Viral Hepatitis In the Criminal Justice Profession TCOLE Course # 3804 THREE Texas Commission On Law Enforcement and Texas Department of State Health Services

Unit Three 3.0 personal occupational 3.0 Functional Area: This section will introduce the participant to personal and occupational practices that place individuals at risk of exposure to HIV, HBV, and HCV.

Learning Objective 3.0 Learning Objective 3.0 : The participant will be able to explain personal and occupational practices that place individuals at risk of exposure to HIV, HBV, and HCV. Learning Objective 3.1 Learning Objective 3.1 :The participant will be able to list personal behavior that places individuals at risk of exposure to HIV, HBV, and HCV, and be able to list three substances that impair judgments that lead to high risk behaviors. Learning Objectives

Learning Objective 3.2 Learning Objective 3.2 :The participant will be able to define occupational exposure, identify occupational risks to law enforcement and corrections personnel and theprecautions that will reduce the chance of exposure. Learning Objective 3.3 Learning Objective 3.3 :The participant will be able to list specific criminal justice job related behaviors that may put them at risk for occupational exposure. Learning Objectives

Learning Objective 3.4 Learning Objective 3.4 :The participant will be able to list universal precautions for occupational exposure to HIV, HBV, and HCV. Learning Objective 3.5 Learning Objective 3.5 :The participant will be able to list the prevalence of reported HIV, HBV, and HCV cases. Learning Objectives

Learning Objective 3.1 Learning Objective: The participant will be able to identify personal behavior that places individuals at risk of exposure to HIV, HBV, and HCV.

3.1 list personal behavior that places individuals at risk of exposure to HIV, HBV, and HCV A. HIVHBVHCV A. Factors in the “Formula” for assessing HIV, HBV, and HCV risk fluid 1. Which body fluid (blood, semen etc…?) entry 2. Route of entry into body (blood stream, mucous membranes) Dose 3. Dose of infected fluid

A. A. Factors in the “Formula” for assessing HIV, HBV, and HCV risk out 4. How long fluid is out of body exposures 5. Number of exposures host 6. Condition of host (how high is their viral load) 3.1 list personal behavior that places individuals at risk of exposure to HIV, HBV, and HCV

A. A. Factors in the “Formula” for assessing HIV, HBV, and HCV risk immune system 7. Condition of recipient ( immune system, other STDs) 3.1 list personal behavior that places individuals at risk of exposure to HIV, HBV, and HCV

B. B. In descending order; the HIV risks for anal, vaginal, and oral sex: anal 1. Receptive anal intercourse with ejaculation and no condom vaginal 2. Receptive vaginal intercourse with ejaculation and no condom 3.1 list personal behavior that places individuals at risk of exposure to HIV, HBV, and HCV

B. B. In descending order; the HIV risks for anal, vaginal, and oral sex: intercourse 3. Insertive anal intercourse and no condom vaginal 4. Insertive vaginal intercourse and no condom 3.1 list personal behavior that places individuals at risk of exposure to HIV, HBV, and HCV

B. B. In descending order; the HIV risks for anal, vaginal, and oral sex: analvaginal 5. Receptive anal or vaginal intercourse with a condom* 6. Insertive anal or vaginal intercourse with a condom* 3.1 list personal behavior that places individuals at risk of exposure to HIV, HBV, and HCV

B. B. In descending order; the HIV risks for anal, vaginal, and oral sex: oral 7. Receptive oral sex with a man with ejaculation woman 8. Oral sex with a woman 3.1 list personal behavior that places individuals at risk of exposure to HIV, HBV, and HCV

B. B. In descending order; the HIV risks for anal, vaginal, and oral sex: man 9. Receptive oral sex with a man with pre-cum 3.1 list personal behavior that places individuals at risk of exposure to HIV, HBV, and HCV

B. B. In descending order; the HIV risks for anal, vaginal, and oral sex: man 11. Receptive oral sex with a man with a condom* vulva 12. Receptive oral sex with a woman with a latex barrier over the vulva *Risk is lower if there is no contact. 3.1 list personal behavior that places individuals at risk of exposure to HIV, HBV, and HCV

C. C. High-risk individuals are those who participate in behaviors that increase the chance of exposure to HIV, HBV, and HCV. Malemale 1. Male to male sexual intercourse needles syringes 2. People who share needles, syringes, or sharps 3.1 list personal behavior that places individuals at risk of exposure to HIV, HBV, and HCV

C. C. High-risk individuals are those who participate in behaviors that increase the chance of exposure to HIV, HBV, and HCV. money drugs 3. People who have sex for money or drugs partners 4. People who have multiple sex partners 3.1 list personal behavior that places individuals at risk of exposure to HIV, HBV, and HCV

C. C. High-risk individuals are those who participate in behaviors that increase the chance of exposure to HIV, HBV, and HCV. intercourse 5. People who have sexual intercourse with any of the above 3.1 list personal behavior that places individuals at risk of exposure to HIV, HBV, and HCV

D. D. The use of substances which impair judgment can result in the high-risk behaviors listed above. These substances include: intravenous 1. intravenous drugs alcohol 2. alcohol 3.1 list personal behavior that places individuals at risk of exposure to HIV, HBV, and HCV

D. D. The use of substances which impair judgment can result in the high-risk behaviors listed above. These substances include: cocaine 3. cocaine marijuana 4. marijuana 3.1 list personal behavior that places individuals at risk of exposure to HIV, HBV, and HCV

D. D. The use of substances which impair judgment can result in the high-risk behaviors listed above. These substances include: brain’s 5. other substances that diminish the brain’s ability to function normally 3.1 list personal behavior that places individuals at risk of exposure to HIV, HBV, and HCV

3.2 Learning Objective Learning Objective: The participant will be able to define occupational exposure, identify occupational risks to law enforcement and corrections personnel and the precautions that will reduce the chance of exposure.

3.2 occupational exposure and risks to law enforcement and corrections personnel A. A. HIV and hepatitis are viruses that can be contracted anywhere—not just the workplace. personal work 1. Employees should be as careful in their personal lives as they are at work about protecting themselves against infection.

A. A. HIV and hepatitis are viruses that can be contracted anywhere—not just the workplace. myths 2. Many myths still persist about how these viruses are transmitted (No, you can’t get AIDS from a mosquito bite), and it is to every employee’s advantage to get the facts. 3.2 Occupational exposure and risks to law enforcement and corrections personnel – Cont’d

B. B. What is an occupational exposure? On January 20, 1990, the CDC published the definition of an occupational exposure in the Morbidity and Mortality Weekly Report. This definition says that an occupational exposure occurs when the following criteria are met: 3.2 Occupational exposure and risks to law enforcement and corrections personnel – Cont’d

B. B. occupational exposure occurs when the following criteria are met: 1. exposure 1. The exposure occurs during the performance of the employee’s duties; 2. route 2. There is a route of exposure in other words, a way for the viruses to enter your body. This could happen in one or more of the following ways: 3.2 Occupational exposure and risks to law enforcement and corrections personnel – Cont’d

B. 2. B. 2. This could happen in one or more of the following ways: a. percutaneous a.) A percutaneous injury (i.e., needle stick, puncture wound or cut with a contaminated object, or from a human bite that breaks the skin); or 3.2 Occupational exposure and risks to law enforcement and corrections personnel – Cont’d

SEIZING NEEDLE FROM DRUG USER

B. 2. B. 2. This could happen in one or more of the following ways: b. mucous b.) Contact with the mucous membrane linings of the eyes, nose and/or mouth; or 3.2 Occupational exposure and risks to law enforcement and corrections personnel – Cont’d

B. 2. B. 2. This could happen in one or more of the following ways: c. skin c.) Contact with the skin, especially if the exposed skin is chapped, abraded or afflicted with dermatitis, or the contact is prolonged or involving an extensive portion of the body 3.2 Occupational exposure and risks to law enforcement and corrections personnel – Cont’d

C. C. If the employee is exposed to a body fluid to which universal precautions apply. These fluids include: 1. Blood 1. Blood (including menstrual) 2. Semen 3. Vaginal 3. Vaginal secretions 3.2 Occupational exposure and risks to law enforcement and corrections personnel – Cont’d

C. C. These fluids include – Cont’d: 4. Amniotic 4. Amniotic fluid 5. Cerebrospinal 5. Cerebrospinal (brain and backbone) fluid 6. Synovial 6. Synovial (joint) fluid 7. Pleural 7. Pleural (chest) fluid 3.2 Occupational exposure and risks to law enforcement and corrections personnel – Cont’d

C. C. These fluids include – Cont’d: 8. Peritoneal 8. Peritoneal (abdominal) fluid 9. Pericardial 9. Pericardial (heart) fluid 3.2 Occupational exposure and risks to law enforcement and corrections personnel – Cont’d

C. C. These fluids include – Cont’d: 10. Saliva 10. Saliva (in a dental setting is considered a risk factor for HIV exposure since it is possible that blood or tissue may be present in the saliva). 3.2 Occupational exposure and risks to law enforcement and corrections personnel – Cont’d

D. blood D. In a law enforcement setting or correctional setting, the only fluids you should be concerned about coming into contact with are blood, semen, and possibly vaginal secretions. All the other fluids listed above are body cavity fluids and unless you are working in an operating room, you 3.2 Occupational exposure and risks to law enforcement and corrections personnel – Cont’d

Police breaking up fight between naked males

D. D. Cont’d: should never be exposed to them. (If you are a correctional officer and get spinal fluids on your hands, you’re probably operating outside of your job description.) 3.2 Occupational exposure and risks to law enforcement and corrections personnel – Cont’d

E. E. The body fluids that correctional staff is most likely to come into contact with don’t transmit HIV or hepatitis unless visible blood is present. These fluids include: 1. Feces 1. Feces 2. Nasal 2. Nasal secretions 3.2 Occupational exposure and risks to law enforcement and corrections personnel – Cont’d

E. E. These fluids include: 3. Saliva 3. Saliva * 4. Sputum 5. Sweat 5. Sweat 6. Tears 3.2 Occupational exposure and risks to law enforcement and corrections personnel – Cont’d

E. E. These fluids include: 7. Urine 7. Urine 8. Vomit 3.2 Occupational exposure and risks to law enforcement and corrections personnel – Cont’d

Saliva risk factor B * Saliva in a human bite is considered a risk factor for the transmission of hepatitis B only, although the CDC has never documented a case of a person contracting HBV this way. 3.2 Occupational exposure and risks to law enforcement and corrections personnel – Cont’d

F. NOTE F. NOTE: What are my chances of contracting HIV or hepatitis if I have an exposure? – Cont’d 1. needle 1. HIV: When we talk about the risks of occupational exposure we always use the example of getting stuck with a known HIV-positive patient’s contaminated (bloody) needle. 3.2 Occupational exposure and risks to law enforcement and corrections personnel – Cont’d

F. NOTE F. NOTE: What are my chances of contracting HIV or hepatitis if I have an exposure? – Cont’d 2. HIV 2. Not just anybody’s needle—an HIV -positive patient’s needle 3.2 Occupational exposure and risks to law enforcement and corrections personnel – Cont’d

F. NOTE F. NOTE: What are my chances of contracting HIV or hepatitis if I have an exposure? – Cont’d 3. hypodermic 3. And not just any kind of needle—a used hypodermic (hollow-bored) syringe. 3.2 Occupational exposure and risks to law enforcement and corrections personnel – Cont’d

F. NOTE What are my chances of contracting HIV or hepatitis if I have an exposure? Cont’d F. NOTE: What are my chances of contracting HIV or hepatitis if I have an exposure? Cont’d 4. tattoo 4. In corrections, tattoo needles found under bunks and behind dayroom benches are usually made from pieces of wire or staples filed to a point and therefore are far less of a risk than hypodermics. 3.2 Occupational exposure and risks to law enforcement and corrections personnel – Cont’d

LEARNING OBJECTIVE Learning Objective: The student will be able to list specific criminal justice job related behaviors that may put them at risk for occupational exposure.

3.3 Justice job related behaviors at risk for occupational exposure 3.3 Justice job related behaviors at risk for occupational exposure. A. precautions A. Law enforcement and corrections personnel may be at risk if they fail to utilize precautions when: 1. blood 1. Encountering blood or potentially infectious body fluids, cleaning up body fluid spills

A. A. Law enforcement and corrections personnel may be at risk if they fail to utilize precautions when: 2. body 2. Conducting body searches, cell searches, or handling evidence that results in punctures of the skin 3.3 Justice job related behaviors at risk for occupational exposure 3.3 Justice job related behaviors at risk for occupational exposure. Cont’d

A. A. Law enforcement and corrections personnel may be at risk if they fail to utilize precautions when: 3. fights 3. Intervening in fights : 3.3 Justice job related behaviors at risk for occupational exposure Cont’d 3.3 Justice job related behaviors at risk for occupational exposure Cont’d.

A. 3. A. 3. Intervening in fights: a. penetrate a.) As a law enforcement or correctional officer, you are not at risk if potentially infectious body fluids are thrown at you and do not penetrate the skin. 3.3 Justice job related behaviors at risk for occupational exposure 3.3 Justice job related behaviors at risk for occupational exposure. Cont’d

A. 3. A. 3. Intervening in fights: b. hygiene b.) You must, however, use common sense and good personal hygiene since other disease causing organisms may be present. 3.3 Justice job related behaviors at risk for occupational exposure 3.3 Justice job related behaviors at risk for occupational exposure. Cont’d

LEARNING OBJECTIVE Learning Objective: The participant will be able to list universal precautions for occupational exposure to HIV, HBV, and HCV.

3.4 precautions for occupational exposure to HIV, HBV, and HCV. A. infected A. Treat all persons as if potentially infected. B.Gloves B. Gloves should be worn during contact with blood or other body fluids that could possibly contain visible blood, such as urine, feces, or vomit

Law Enforcement needle puncture proof gloves

B. Cont’d exposure B. Cont’d: Gloves are recommended when conducting cell, clothing and body cavity searches, as well as in other situations where exposure to blood is likely to take place. 3.4 precautions for occupational exposure to HIV, HBV, and HCV….Cont’d

B. Cont’d protection B. Cont’d: Officers should select the type of glove that provides the best balance of protection and search efficiency. 3.4 precautions for occupational exposure to HIV, HBV, and HCV….Cont’d

C.- Cont’d: Cuts, sores, or breaks skin C.- Cont’d: Cuts, sores, or breaks on both the care giver’s and patients exposed skin should be covered with bandages. 3.4 precautions for occupational exposure to HIV, HBV, and HCV….Cont’d

D. washed bloodbody fluidsblood D. Hands and other parts of the body should be washed immediately after contact with blood or other body fluids, and surfaces soiled with blood should be disinfected appropriately 3.4 precautions for occupational exposure to HIV, HBV, and HCV….Cont’d

E. razors toothbrushes E. Practices that increase the likelihood of blood contact, such as sharing of razors and toothbrushes, should be avoided. 3.4 precautions for occupational exposure to HIV, HBV, and HCV….Cont’d

F.Needles F. Needles and other sharp instruments should be used only when medically necessary and handled according to recommendations for health-care settings 3.4 precautions for occupational exposure to HIV, HBV, and HCV….Cont’d

F. Cont’d: F. – Cont’d: 1. needles 1. Do not put caps back on needles by hand or remove needles from syringes 3.4 precautions for occupational exposure to HIV, HBV, and HCV….Cont’d

F. – Cont’d F. – Cont’d: 2. puncture 2. Dispose of needles in puncture - proof containers out of the reach of children and visitors. 3.4 precautions for occupational exposure to HIV, HBV, and HCV….Cont’d

LEARNING OBJECTIVE Learning Objective: The student will be able to list the prevalence of reported HIV, HBV, and HCV cases.

3.5 Prevalence of reported HIV, HBV, and HCV cases 3.5 Prevalence of reported HIV, HBV, and HCV cases. A. HIV A. To date there have been no reported cases of HIV in correctional or law enforcement officers a result of occupational exposure. Also, published reports do not document any increased risk for HBV infection among public safety workers.

B. CPR B. To date no reported HIV infections as a result of CPR, with or without a one way pocket mask. C. contaminated C. To date no reported HIV infections as the result of contaminated surfaces or environment 3.5 Prevalence of reported HIV, HBV, and HCV cases 3.5 Prevalence of reported HIV, HBV, and HCV cases.

Keeping Your Guard Up (Length: 23 minutes) Learn what you need to know to stay safe Exposure Risks for HIV and Hepatitis for Peace Officers, Detention and Correction Officers Contact the CDC National Prevention Information Network at

Questions?

77 DEFINE & PROCESS Process: Define 3.1: Define 3.1: Explain and list personal behavior that places individuals at risk of exposure to HIV, HBV, and HCV, and be able to list three substances that impair judgments that lead to high risk behaviors

78 DEFINE & PROCESS Process: Define 3.2: Define 3.2: Define occupational exposure, identify occupational risks to law enforcement and corrections personnel and the precautions that will reduce the chance of exposure

79 DEFINE & PROCESS Process: Define 3.3: Define 3.3: Explain and list specific criminal justice job related behaviors that may put them at risk for occupational exposure.

80 DEFINE & PROCESS Process: Define 3.4: Define 3.4: List universal precautions for occupational exposure to HIV, HBV, and HCV.

81 DEFINE & PROCESS Process: Define 3.5: Define 3.5: List the prevalence of reported HIV, HBV, and HCV cases.

SOURCES All Course Sources and/or Resources are listed in your Participant Handout HIV-AIDS & Viral Hepatitis in CJ Profession TCOLE Course # 3271 Bexar County Constable Office PCT#4

“Knowledge is “POWER” Stay informed, stay SAFE, stay Vigilant & stay Alive”

TAKE A 15-MINUTE BREAK