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Objective: To characterize occupationally acquired human immunodeficiency virus (HIV) infection detected through case surveillance efforts in the United States., Design: National surveillance systems, based on voluntary case reporting., Setting: Healthcare or laboratory (clinical or research) settings., Patients: Healthcare workers, defined as individuals employed in healthcare or laboratory settings (including students and trainees), who are infected with HIV., Methods: Review of data reported through December 2001 in the HIV/AIDS Reporting System and the National Surveillance for Occupationally Acquired HIV Infection., Results: Of 57 healthcare workers with documented occupationally acquired HIV infection, most (86%) were exposed to blood, and most (88%) had percutaneous injuries. The circumstances varied among 51 percutaneous injuries, with the largest proportion (41%) occurring after a procedure, 35% occurring during a procedure, and 20% occurring during disposal of sharp objects. Unexpected circumstances difficult to anticipate during or after procedures accounted for 20% of all injuries. Of 55 known source patients, most (69%) had acquired immunodeficiency syndrome (AIDS) at the time of occupational exposure, but some (11%) had asymptomatic HIV infection. Eight (14%) of the healthcare workers were infected despite receiving postexposure prophylaxis (PEP)., Conclusions: Prevention strategies for occupationally acquired HIV infection should continue to emphasize avoiding blood exposures. Healthcare workers should be educated about both the benefits and the limitations of PEP, which does not always prevent HIV infection following an exposure. Technologic advances (eg, safety-engineered devices) may further enhance safety in the healthcare workplace.

Objective: To characterize Asians and Pacific Islanders in the United States with reported acquired immunodeficiency syndrome (AIDS)., Methods: AIDS surveillance data reported through June 1998 were analyzed. Characteristics of cumulative case patients, rates of AIDS incidence in 1996 through 1997, and trends from 1982 through 1996 were analyzed., Results: Through December 1998, 4,928 Asian and Pacific Islander adults and 46 Asian and Pacific Islander children with AIDS were reported in the United States. Of the total cases, 89% were in men, and 79% of those were in men who have sex with men (MSM). Five states, which account for 63% of the Asian and Pacific Islander population in the United States, reported 78% of the cases: California (45%), Hawaii (12%), New York (15%), Texas (3%), and Washington (3%). Of the 92% of Asian and Pacific Islander patients with country of birth information, 59% were foreign-born, a percentage that corresponds to the distribution in the general population. The overall incidence rate per 100,000 for 1996 through 1997 was 12.8 (21.3 for men; 3.3 for women). The highest rate was in the Northeast (15.9), followed by the West (13.8), South (10.6), and Midwest (5.7). Tuberculosis, reported for 6% of Asians and Pacific Islanders, was higher among foreign-born than among U.S.-born Asians and Pacific Islanders (8% and 4%, respectively). Between 1982 and 1996, AIDS incidence among MSM increased and peaked in 1994. Among heterosexual contacts and injection drug users, incidence has increased but remained low., Conclusions: The AIDS epidemic among Asians and Pacific Islanders in the United States has primarily affected MSM and is concentrated in a few states where most Asians and Pacific Islanders reside. Prevention activities should include consideration of cultural diversity and an understanding of cultural norms regarding sexuality. Additional information on risk behaviors and seroprevalence among Asian and Pacific Islander MSM is needed to better guide prevention planning.

Through December 1994, 41 healthcare workers with a documented seroconversion to human immunodeficiency virus (HIV) in temporal association to an occupational exposure were reported to the Centers for Disease Control and Prevention (CDC). Each tested positive for HIV antibodies within 12 months of the occupational exposure. Two (5%) of the 41 tested negative for HIV antibodies >6 months following the occupational exposure but were seropositive within 12 months of the injury. Both denied any subsequent exposures to HIV after the initial exposure, and in one case genetic sequencing confirmed the source of the infection. Four of the healthcare workers took postexposure zidovudine prophylaxis; each reported an acute retroviral syndrome within 6 weeks of their exposure, and each of the four seroconverted to HIV within 6 months of the exposure. Our data suggest that zidovudine prophylaxis does not delay the development of HIV antibodies beyond 6 months. Because many of the healthcare workers had follow-up testing at irregular intervals, with long periods between tests, it was not possible to define precisely when seroconversion occurred. However, our findings are compatible with previously published estimates that 95% of infected persons will develop HIV antibodies within 6 months of infection.