Is there any extra concerns with divers who have HIV?

[mdjh51]

Human immunodeficiency virus targets t cells of the humoral branch of the immune system. The helper T cells are the "quarterbacks" of the immune mediated response. Without them, the body is unable to mount an effective defense against the simplest of organisms. HIV does not kill you. The opportunistic infection that forms when an individual is immunocompromised is what kills you. Advances in management of HIV over the last 20 years mean that the average person with HIV will live as long as an individual with Congestive Heart Failure or with Chronic Onbstructive Pulmonary Disease. As long as the individual is well medicated (and tolerated), viral loads are kept below detectable thresholds, and CD4 counts are normal, there should be no reason for an HIV patient to refrain from diving. Universal precautions are ALWAYS a good idea when helping an individual you are not familiar with.

 

[mdjh51]

HIV simply impacts your imune system making you seceptable to other forms of virisis. I really wouldnt see how diving could or would affect a person with HIV in the slightest.

Without an immune system, we have no defense against the simplest of pathogens. This holds true in the water, on a dive trip to ::insert destination here::, or in our own homes. HIV attacks the immune system, causing it to become ineffective. This allows for opportunistic infections to set in. It is not just viruses that take advantage of the weakened immune system, but bacteria, yeast, fungi, mold, etc.

 

[Lloyd]

I don't know if there could be complications from HIV Associated Dementia. Check out this link: http://www.emedicine.com/med/topic3151.htm
A high number of patients will have it. Does the higher O2 concentration increase the damage? Does it make you more succeptable to seize? ADC alone could make you unfit to dive. Could nitrogen narcosis push a mild case over the edge?Alot of risk factors to concider with no clear cut answers.
Lloyd

 

[Ishie]

Well of course one should ask the additional question, "Are there any concerns for diving WITH divers with HIV".
This would fall into 2 categories:
a) would you have any concern buddy breathing with an HIV positive buddy?
and
b) would you need to monitor with extra attention an HIV positive buddy? Say for increased narcosis susceptibility or anything else?

In the case of (a) saliva is not supposed to be a contaminant but on the other hand some hard rubber regulator mouthpieces can scratch gums - could this be a transfer vector?

I wouldn't think buddy breathing would be as much of a concern, though the mouthpiece scratching gums is a good point. But when you pass the reg through the water, since HIV is so susceptible to the elements, I'd think the salt water would destroy it fast. Perhaps taking a little more time passing the reg and give it a swish through the water. It's not universal precautions, but it's probably sufficient.

First aid, of course, would require more attention. Lacerations and scrapes are an obvious one, but I'd also pay more attention to regular mouth to mouth if it were required, since embolizing and barotrauma, both potential diving injuries, can cause bleeding from the mouth and nose. If an HIV positive diver did a panic ascent from depth and wasn't breathing on the surface, I'd be extremely nervous to do mouth to mouth without proper safety equipment. If I were diving with an HIV positive diver, I would probably add a pocket mask to my dive equipment for that reason.

 

[Fotoz4FX]

I was an EMT/Paramedic and, as a result of trauma to myself and typical burnout in this profession, I let my certifications lapse. As a Hospital Corpsman of 16 years (and this is just my interpretation of the facts), HIV is not much of a concern in sharing air unless the air source is mutual (a bad practice to begin with since most who run out of air may be in a 'panic' mode and not be willing to 'share' what you gave in the first place... your regulator).
HIV is a weak virus which cannot survive even for short periods out of the host body - the real demon would be Hepatitis B which can survive in a spore state for very long periods of time. They are both killers so doesn't solo diving have an allure now !?
My pony bottle is available for sharing so long as I have my supply of air but I am NOT sharing my regulator with some wide-eyed dive 'buddy' who I might have to stab repeatedly in order to get it back.
Stupid is what stupid does... I always teach my Rescue Rangers (those divers who want to be rescue divers or Divemasters) "remember... it's THEIR emergency, don't make it yours too".
You are a resource to a paniced diver... nothing more. HIV or not, you may have a fight on your hands to survive... know your buddy and check their gear too - your attentiveness to your buddy may be what saves both of your lives.