To the Editor. — Health care providers are known to be at risk of exposure to patients infected with the human immunodeficiency virus 1 (HIV-1). The risk of transmission of infection in the health care setting, although small, is not zero.1 In psychiatric inpatient settings, patients may exhibit behavior that facilitates the transfer of infection to physicians and also to other patients. These activities include continued drug use and sexual activity (factors known to facilitate transmission) and biting (an act with a less clear risk).
Psychiatric patients have been found to have a higher rate of substance abuse than the general population.2 Since intravenous drug use is known to be a risk factor for HIV infection, these patients would be expected to have a higher rate of HIV infection than the general population. However, this has not been looked at previously.
There are also several factors that may