What is most important in HIV/AIDS prevention is that people not limit themselves to one approach over the other. They may take from several approaches, as indicated by the needs of the individuals and communities that are targeted by preventive measures:

Abstinence: Abstinence is the only 100% effective method of preventing sexually transmitted HIV infection. Also, effectively discouraging young people from becoming sexually active prevents unwanted pregnancy and other sexually-transmitted diseases. However, studies have shown that up to 60% of young people who vow to remain abstinent do not actually do so.

Condoms: In the current conservative climate, condom use is often considered the last line of defense, rather than the first. According to research by UNAIDS, condom use is 90% effective in preventing HIV transmission. Education about how, when, and why to use condoms is an important component of any HIV prevention programs. Since condoms can break or slip, people should not rely on them as their only defense against HIV but should use a spermicide, such as nonoxynol-9 for added protection. Transmission of HIV is more likely where the skin is broken, for example due to anal sex, rough or violent sex, or the presence of sexually transmitted infections. Using a condom is very important under these circumstances

Needle exchange/safe needle programs: Needle exchange programs are not without controversy, as the use of illicit IV drugs is illegal in the United States. Therefore, some people argue that the program is rewarding and abetting illegal activity. Most states, including Florida, continue to restrict access to syringes by enforcing “drug paraphernalia” laws, and regulating the purchase and sale of syringes in pharmacies. However, a needle-exchange program, coupled with methadone substitution for injecting drug use, and condom distribution and instruction, can be an effective means of reducing HIV infection. If needle exchange programs are not available, education efforts need to be made to advise people not to share needles, cotton, syringe, or cookers - all which may be contaminated with blood. People need to be taught to use new needles or to clean needles with full strength bleach and rinse thoroughly with water before each use.

Substance abuse programs: The United States has approximately 1.5 million injection drug users and many additional people who use other drugs, such as cocaine, crack, or alcohol. However, there are only about one-half million drug treatment slots available. Therefore, meeting the needs of HIV positive people who suffer from substance abuse presents a particular challenge.

Education/counseling programs: There is a continuing need for community outreach programs to educate high risk populations about HIV/AIDS. However, money necessary to fund such programs is sometimes inadequate. The present administration has emphasized volunteer and faith-based programs, and there are a number of such programs in place.

Universal/Standard precautions: Universal precautions are mandated by OSHA for health care workers, as a way to reduce risk from bloodborne pathogens, e.g. HIV, Hepatitis A, B, C, Staph, Strep, Syphillis, TB, etc.

Standard precautions have since been promoted by the CDC to reduce the transmission of all infectious diseases. Workers are to treat all bodily fluids, except perspiration, as though they are infectious and use appropriate care to avoid contact. The use of Universal/Standard precautions protects not only the workers but patients as well. The following precautions should be taken:

Gloves: Should be used for any treatment or procedures that involve contact with mucous membranes, contaminated or non-intact skin, or body fluids or items soiled with body fluids. Gloves should be used only once and should be discarded in a special container separate from other trash.

Hand washing: Should be done immediately after removing gloves. Obviously, handwashing should be done if any blood or body fluid gets on the hand or other body surface. It should be done immediately after each contact with a patient, since ANY patient may be HIV positive.

Protective clothing (masks, goggles, gowns): Surgical mask and eyewear should be worn during any task that may cause exposure of mouth, nose, and eyes to blood or body fluids. Disposable gowns or aprons should be used when blood or body fluids may splash on clothes. Cloth gowns or aprons should be washed according to instructions for washing linens soiled with blood.

Safety precautions with needles: Should always use disposable needles; Should not recap or purposely bend needles; Should discard needles in the way recommended by health care agency; Should be placed in puncture-proof container, specifically marked, and not overfilled; Needlesticks should be immediately reported to health care agency.

Disposal of waste products and washing of soiled linens; Waste products should be disposed of in red plastic bags, double-bagged; Linens or clothing soiled with blood must be washed separately from other laundry, using detergent and germicide.

Guidelines for sterilization or disinfection: Should use chemical germicides registered with the EPA for sterilization or disinfection and chemicals should be used only in recommended concentrations and only with proper ventilation.

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