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If necessary, a clinical psychologist, a medical psychologist, a psychiatrist-narcologist, a psychotherapist, an obstetrician-gynecologist, a dermatovenerologist, an epidemiologist, doctors of other specialties can be involved in working with victims.
Comprehensive assessment includes: assessment of the type of contact; assessing the need for HIV PEP; testing for HIV of the contact person and source of infection (if possible); if the source is infected with HIV, find out if he received ART.
If the victim is a woman, a pregnancy test should be done to find out if she is breastfeeding. Recommended for doctors responsible for the care of HIV-infected people and / or physicians Medical organizations responsible for monitoring contacts and/or doctors of the municipality where the emergency occurred, for emergency prevention of the disease to persons at risk of contracting HIV infection, prescribe ARVP as a method of post-exposure prophylaxis (PEP) to prevent HIV infection [190, 191] (2B ).
Cases of the development of HIV infection have been recorded without any convincing explanation for the ineffectiveness of PEP.
Case/control data, observational data and monkey models are available. It is recommended that physicians responsible for the care of HIV-infected patients and/or physicians of the MI responsible for the surveillance of contacts and/or physicians of the MI where the emergency has occurred prescribe PEP [190,191,192,193] (2B): to the following contingents: healthcare workers and other persons injured while providing care to patients; with the following types of contacts, in which HIV PEP is justified - contact with blood, blood-stained saliva, breast milk, secretions from the genital organs, cerebrospinal, amniotic, peritoneal, synovial, pleural and pericardial fluids; for the following types of exposure requiring HIV PEP: through mucous membranes (splashes in the eyes, nose or oral cavity); parenteral.
Comments: HIV PEP is not required in the following cases : with proven positive HIV status of the contact person; with proven HIV-negative status of the source; in contact with biological fluids that do not pose a significant risk: lacrimal fluid, saliva without blood, urine, sweat [190, 191, 192] (2B). recommended to doctors of the Moscow Region, where the emergency occurred, to provide first aid in the form of self-help to the victim, to involve paramedical personnel in first aid, as well as other persons at the scene of the accident [3, 4, 5, 8, 37.190193] (5Ñ ): in case of cuts and injections, immediately remove gloves, wash hands with soap and water under running water, treat hands with 70% ethanol solution **, lubricate the wound with 5% iodine alcohol solution ; in case of contact with blood or other biological fluids on the skin, treat this place with 70% ethanol solution**, wash with soap and water and re-treat with 70% ethanol solution**; in case of contact with blood and other biological fluids on the mucous membrane of the eyes, nasal cavity and mouth: rinse the mouth with plenty of water and rinse with 70% ethanol solution**, rinse the mucous membrane of the nose and eyes with plenty of water (do not rub); in case of contact with blood and other biological fluids on a dressing gown, clothes: remove work clothes and immerse in a disinfectant solution.