HIV in the Dojo

If you find that one of the students at your dojo is HIV positive, what would you do?

Originally posted by Unregistered If you find that one of the students at your dojo is HIV positive, what would you do?

Practice with, learn from, and offer to teach. HIV isn't an issue unless blood is let. Even then, you are 100 times more likely to contract hepatitis B from infected blood than you are HIV.

Well, I don't have a dojo (here sticks out tounge at those laughing at the very idea ) but this is one reason I am annoyed at those who carelessly bleed on others, the mat, etc., and train without covering wounds. Hepatitis is another reason.

I would make sure at LEAST that student knew s/he really did have to leave the mat immediately if cut, and I'd make sure everyone knew they HAD to wear gloves when cleaning up blood. The way to not make this obvious that you are worried about a student is to make this a routine practice (as it should be).

BLEEDING on the mat is much worse than peeing on the mat.
Same for your fellow students.
Try to avoid drawing blood--no jewelry, cut nails, etc.
Proper universal precautions for blood on the mat.
Good personal hygiene for all.

Maybe I am less paranoid than some might be, as I am a physician who treats patients all the time without knowing their HIV status.

To tell you the truth, I would be afraid. But this is me though.

Never thought much about this issue, even though it has crossed my mind a few times. And I don't know what the answer would be. I too am searching for the answer.

Just believe in the truth of the matter and do what is right. Even though, this is easier for me to say than do.

Originally posted by ca <snip> I am annoyed at those who carelessly bleed on others, the mat, etc., and train without covering wounds. Hepatitis is another reason. <snip> BLEEDING on the mat is much worse than peeing on the mat. Same for your fellow students. Try to avoid drawing blood--no jewelry, cut nails, etc. Proper universal precautions for blood on the mat. Good personal hygiene for all. Maybe I am less paranoid than some might be, as I am a physician who treats patients all the time without knowing their HIV status.

FWIW, I think this is a very good and to-the-point post by Colleen. She's a physician. Please listen to her, folks!

I can't tell you the number of times I've had an open cut from someone's long toe nails.

I've also seen people get fingers/thumbs in the eye, etc.

I've even had my gum slashed by a partner's thumbnail. Thank God she had her nails trimmed short.

Best,

"Philadelphia" is a great film about an HIV patient. Ahem. Just thought I'd plug it in, because it's a good film. With Tom Hanks.

Well, I've done different MAs since I was 8 or 9 (and Boxing when I was 5-8)

And I've seen thousands of cuts, bloody scrapes etc. And some worse.

But I can't remember ever seeing someone get their blood on someone else, except on their gi, or the mat.

Oh...and I'm still useless at Martial Arts

Well, here in Bangkok we have a special situation. It is a cultural thing for Thai (and Chinese) men to have long fingernails. (I think it comes from old China where mandarins used to keep their nails long to show that they did not work with their hands, and thus show their status). There is nothing that could convince them to cut their nails short. The result: My hands and wrists look like geographical maps because of the engravings done by my partners. Of course there is a lot of blood involved (it's amazing how much a tiny nail scratch can bleed). I don't think someone could catch HIV this way, but I'm always afraid because of the open wounds. Now I refuse to practice with longnailed guys.

Curiously, ladies keep their nails short

Cheers,
Edward

According to the CDC the risk of HIV transimission during a sporting is extremely low (low enough that there are no documented cases).

There was one karate school that went to court to deny access to a person who was HIV positive. Interestingly, the court thought that the karate school qualified as a public accomodation under the Americans with Disabilities Act, which makes it illegal to deny access to people based on their HIV status. It seems likely that most Aikido dojo would also be subject to similar regulation under the ADA, I would think. The karate school ended up winning the right to refuse access, based mainly on the argument that they practiced an extremely rough style that involved bleeding on a regular basis. Most Aikido schools would have probably have problems making a similar argument (thankfully - I'm perfectly happy with not bleeding on a regular basis ).

Best,

Chris

If you were a teacher at a dojo where there was someone who was HIV positive, what would you do? It's a good possibility that there will be someone there who will be uncomfortable.

How do you know you are not already training with an HIV positive person? They might not even know themselves...

I have had patients who were HIV positive, and others with Hep C, who did not know, and neither did I (at first). After years of caring for them, doing minor surgery, etc., I then found out (and had to tell them) their status. You can't tell by looking at a person, or by the way they dress, or the job they have....

Many first time blood donors who rushed out after 11 September later got the bad news when their blood was rejected...

Universal precautions. Universal precautions. Universal precautions. And no jewelry, and short nails

Originally posted by Unregistered If you were a teacher at a dojo where there was someone who was HIV positive, what would you do? It's a good possibility that there will be someone there who will be uncomfortable.

Nothing other than what I do now. That is, whether you know of someone who's HIV positive or not you should take the same basic precautions.

Uncomfortable? Maybe you should just give them a leper's bell...

As I said before, the CDC rates the chance of transmission during sporting activities as extremely low. There's no reason to treat anybody differently, just take reasonable precautions - the ones that you should be taking anyway.

Best,

Chris

Hello everybody,
Though I never had to train with someone with HIV (unless I didn't know they had it), I don't think I'll have any problem with it. They are just normal people and the only reason for concern is blood mixing with blood. And thanks but I don't see alot of that happening in training.So, actually there is hardly a chance for such a thing to happen, and if someone bleeds, there is no problem to clean it up without touching the blood.
I think everyone should get a fair chance to train.
The problem might start if someone else in the dojo thinks differently, then the situation would be 'me or him', which could lead to an uncomfortable situation. Still, I think an HIV person should be let in the dojo, actualy, if such a situation would arise, I wouldn't like to train with someone who will say 'him or me'.
Hope people in aikido are more grown up to see the reason behind letting a person train or not, and not let superstition rule.
Anat

Jeeez.

You guys are a bit paranoid. The chances of one transmitting HIV during Aikido training is damned near impossible, EVEN IF THE HIV+ PERSON HAS A BLEEDING CUT ON THEIR WRIST DURING TRAINING. It would have to be very deliberate and quite difficult as well as time consuming. HIV does not "soak through skin", nor does it transmit through sweat or saliva. Transmission of the HIV virus is more difficult than cops and nurses would lead one to believe. Ask Colleen :O

I would imagine a LOT of blood would have to be spilled by one apparently unfortunate HIV positive aikidoka, onto the gaping wound of another unfortunate aikidoka. Then I would imagine that both would have to just ignore the blood and continue training (to the horror of the rest of the class), or actually sit there and perform some sort of "blood brother" style transfusion by connecting both of their open wounds together, all on the mat without any concern for, or from, their peers. Fortunately, I've never seen anything this macabre in any dojo, but then I haven't been to very many.

If this type of training happens regularly in one's dojo, I would suggest that person leave it immediately, and not before they called the proper health and sanitation authorities. If it's a normal dojo where injuries are rare and MINOR cuts are rarer, and those "victims" are excused to go politely grab a bandaid when the occasional and inevitable "toenail/fingernail cut" happens, then I can't see HIV being transmitted from person to person in the aikido training environment.

But, I guess if people would rather "be safe than sorry", there's certainly nothing "wrong" with that. I guess one could always snap on their latex gloves before training...

I would be more concerned about borrowing someone's else's cellphone than grabbing someone's wrist if I were THAT worried about diseases....

At our club we have some very basic rules that make sure the place is clean:
1) Before every trainingnight the mats are cleaned.
2) No training with uncovered wounds.
3) You bleed, you cover your wounds and you clean (immedately!!! and dont forget to warn others about blood on the mats as well)
These rules are not there because of the fear for diseases, but as respect toward the dojo and fellow aikidoka.

Risk of aquiring HIV is very small with this kind of contact. HIV just isnt that contagious!! You need really good blood to blood contact to exchange HIV trough (accidental) wounds. (Of course if you do the kind of cut your hand bloodbrother banding thingy in your dojo then it would be a completely different story, but to my knowledge this is not common practise in Aikido ) If you are afraid of catching diseases in the dojo, there are far more contagious diseases around like TB, Hepatites or Meningites to worry about.

Besides it also depends strongly on where you are and among which people:

• In subsaharan Africa chances of meeting someone who is HIV infected are real as over 8% of the adult population is infected (this is just an overall rate, some areas have very very high prevalence rates as other seemed to have missed the epidemic sofar)
• In the USA chances of meeting someone who is infected are small with 0.6% of the adult population infected (Here a nice effect occures as only 27 states repported to have HIV at all, yet the nation wide prevalance is 0.6%, it must be obvious that there is no homogenieus spread of HIV in the USA. Disturbing however is the observation that more than 22% of all incidence cases is confirmed due to heterosexual contact, and, more worrying, epidemiological data and special HIV surveys indicate that even more
  incident cases should be contributed to hetero sexual contact. This is also the reason for UNAIDS to list hetero sexual contact as an important method of transmission of HIV in the USA.
• In the Netherlands chances of meeting someone infected with HIV are smaller with less than 0.3% of the adult population infected. Although the number of incidence case due to hetero sexual contact seems to have rissen a bit, the main transmision is still confined to druguse and homosexual contact.
• In the UK chances of meeting someone with HIV are small with less than 0.3% of the adultpopulation infected. However 2/3 of all cases occure in London, mainly among homosexual men. Hetero sexual contact does not seem
  to be an important way of transmission, but reports indicate increasing high levels of high risk sexual behaviour among young adults.
• In Australia and NewZeeland chances of meeting someone with HIV are very small as less than 0.1% of the adultpopulation is infected. Closely confined to homosexual contacts, or more recently, also to men that work abroad
  (SE Asia) and who have a second wife in those countries.

Sources: UNAIDS Epiupdate2001, UNAIDS factssheets.

Stay healthy,
dont do drugs
and if you are gonna have sex, make sure you are gonna have safe sex.
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It would be very wrong to make other people aware that someone has HIV+

It's quite obvious that people are scared of aids.

Anyway as long as you dont take the blood of the mats and then stick it inside yourself you should be alright. :-P

Infact I don't worry about this, and sometimes when I help close up at night I clean blood, infact I cleaned blood tonight, and I never wore gloves, I just wached my hands when I was done. If the blood was still wet and my hands were cut then i'd probably wear gloves while cleaning it.

Erik's post says it all. The rule about cleaning up your own blood right away is as sound as you can get. There are a lot tougher things out there than just HIV - hepatitis comes to mind.

Even so it is just common politeness.

Doing a search via Google on the phrase "blood borne pathogen policy" turned up a few interesting links. Here are two of them that are Aikido related:

http://www.aikiweb.com/misc/pathogen.html
- an example of one dojo's policy.

http://www.bujindesign.com/newslette...raining2.shtml
- One of two safety/health forms presented in the March 2001 issue of the BuJin newsletter.

And here are two that are not specific to Aikido:


http://www.unr.edu/hcs/osn/blood_borne_pathogen_exposure_gu.htm
- Guidelines from the University of Nevada, Reno, Orvis School of Nursing. Two interesting quotes from this site:

"The Centers for Disease Control (CDC) does not recommend barring HIV-infected health care workers from practicing their profession."

and

"To mandate that a person infected with HIV be required or requested to notify College authorities is difficult, if not impossible to enforce and legally challengeable."

http://www.aap.org/policy/re9821.html

- policy statement from the American Academy of Pediatrics, dated December of 1999. This contains statistics on the odds of infection. It also contains the following sentence in a statement regarding confidentiality:

"Testing of athletes for these viral infections is not indicated. Infected athletes should be told that they have a very small risk of infecting other competitors. This risk, although unknown for any sport, is probably greatest in wrestling and boxing."

Knowledge about policies in the "outside" world is known as a Good Thing. Bottom line, it seems, is that it would NOT be wise to violate confidentiality, and that HIV infection doesn't even contradict a Health Care professional, much less an athlete.

leh

This is an old thread, but I don't recall anyone saying confidentiality should be violated, or HIV positive folks prevented from training. But people, regardless of their HIV, or Hepatitis, or any other status, should avoid bleeding on the mat or others, and clean up their own blood if possible. All should wear gloves when cleaning up another's blood. Period. The chance of transmission is small, but it is there, and it is not worth the risk to you or your loved ones. Gloves are plentiful and cheap (I might recommend a non-latex powder-free variety if you want to go one step further, as many are now developing latex allergies from frequent exposure to latex in the health care industry).

Health care workers are more likely to get HIV from their patients than patients from their health care workers, although both risks of transmission are negligible. But there is no way I'd touch mucous membranes or body fluids without gloves on, except for life and death emergency... and even then, I pretty much make sure I've got gloves nearby (in my car, in my dojo bag, etc).