When Magic Johnson was diagnosed with HIV and chose initially to continue to play in the NBA, the sporting world didn’t know how to react. The drama was heightened when Magic was scratched on the arm during a game. The scratch led to a lot of unanswered questions because the risk of transmission of HIV in sports was unknown at the time.
Cutaneous Transmission of Bloodborne Pathogens
HIV can be transmitted through a number of avenues including intravenous drug use, unprotected sex, hollow-bore needles, and cutaneous transmission. In the world of sports, the focus was on the prevention of any possible cutaneous transmission. In other words, the greatest possibility of transmission in sports was between two colliding athletes with open wounds (i.e., head-to-head collision).
After years of research studying the possibility of transmission of HIV in all types of sports, there is no evidence that HIV has been transmitted on the field of competition. However, there was one unproven case of possible cutaneous transmission of HIV between two soccer athletes.
One athlete was known to have HIV. The other athlete had never been tested. After the collision, the second athlete tested positive for HIV. However, because the second athlete had not been tested prior to the collision, the case remains as unproven (Management of Bloodborne Pathogens in Sports, 1997).
Although the risk of transmission is extremely low in sports, HIV has changed the way certified athletic trainers approach and handle injured and/or sick athletes.
Universal Precautions in Sports
Universal precautions are now required in the world of sports medicine. They are a set of procedures used by medical professionals to prevent the transmission of bloodborne pathogens. Although always used in the traditional medical settings, the use of personal protective equipment (gloves) is now routinely seen anytime an athlete is treated.
Annual training is required by the Occupational Safety and Health Administration in the management of bloodborne pathogens for all medical personnel who may come into contact with bodily fluids. In sports, the bodily fluid most commonly dealt with is blood.
The goal of universal precautions is to protect the transmission of bloodborne pathogens both from the patient to the medical personnel and from medical personnel to the patient. The safest mindset of the medical professional is to assume that all patients may be infected, therefore all patients (athletes) are treated the same – with care and caution at all times.
Procedures to Reduce Risk of Bloodborne Pathogen Transmission in Sports
Procedures specific to treating sports injuries are now in place and regularly used during sporting events to reduce the risk of transmission of bloodborne pathogens including:
- Regular use of medical gloves when treating an athlete
- Immediate coverage of open/bleeding wounds during an event
- Coverage of athlete’s and medical professional’s pre-existing open wounds with an occlusive bandage
- Use of biohazard kits on sidelines
- Presence of bleach solution and hydrogen peroxide to remove blood on uniforms and equipment
- Presence of extra uniforms on sideline in case blood cannot be quickly removed
Eighteen years ago, Magic Johnson changed the scope of practice in the approach to sports medicine. As current treatments continue to evolve and improve, HIV-positive athletes can continue to compete with their peers. With the addition of Universal Precautions in sports medicine, all athletes can continue to compete together without fear of disease transmission.
Terry Zeigler - Educating through writing with over twenty-five years of experience as a Kinesiology Professor and Certified Athletic Trainer.
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