Ŀ                              Percent transmission between Worker and Patient:                             Ŀ   There is no obvious or "real" answer to this question.                        Suggested: 100    Explanation: below                                         Ĵ   In real life, HIV+ health care workers DO transmit AIDS to HIV negative       patients. Anyone claims otherwise, is just as unrealistic and dangerous       as those who so grossly underplay the long term danger of the AIDS            epidemic. The Simulator is designed to simulate the amount of time a it       takes for a REAL health care worker to contract AIDS under given              circumstances. That number is still the only statistically,                   mathematically accurate result. However, the way the Simulator is             designed, it allows to "flash" other possibilities, display other factors     which participate in the process.                                                                                                                           One of them is the re-transmission of AIDS from an infected health care       worker. The Simulator utilizes Sample Workers (clones of the real, Tested     Worker) and Sample Patients which carry the characteristics of the real       general population. Since the simulation is straightforward (Sample           Patient encounters Sample Worker, the computer checks the HIV status of       each, checks for accident and if there was one, indicates the                 transmission of the virus, BOTH ways. Therefore it also keeps track of        the infected Sample Patients as well. At the end of the simulation, the       number of infected Sample Patients will be displayed.                         Although it is not a mathematically accurate representation of reality        (hence each Sample Patient represents itself, while the single Tested         Worker is represented by 1000 Sample Workers), the process of simulation      can be looked at as a gigantic clinic or hospital where 1000 health care      workers are on duty and tens or hundreds of thousand patients check in        and have an encounter with one of the health care workers.                                                                                                  So, for the sake of scientific curiosity and for experimental purposes,       the program allows to display the number of infected Sample Patient.                                                                                        For reasons explained elsewhere in the program (Library, File 12), the        program assumes that when a Sample Worker has an Accident and the Sample      Patient is HIV positive, the Sample Worker will get infected 100% of the      time. The program does not apply the same rules the other way around.         Therefore, you have to instruct the program whether it should make the        same assumption between a Worker to Patient transmission or should it be      less than 100%. The true rate of transmission is unknown. Enter whatever      number between 1 and 100, which you feel is "fair" or "realistic". The        Simulator will take your input an implement it.                               Suggestions:                                                                              To play it "fair": use 100 (%)                                                To play it realistic: use 30-50%                                   Ŀ                                                                   Discussion:                                                                  Ŀ  Don't forget that the simulated Sample Workers are merely a mathematical      representation of the Chance, the program uses to calculate the length of     the time it will take for Tested Worker (real) to contract AIDS.                                                                                            The "part scores" are mathematically correct, but statistically               insignificant, for the same reasons 1000 Sample Workers can't be identified   with 1000 real workers.                                                      Ŀ                       S T O P !                                     Article 12 In the Library deals with the issue below                          in a far more detailed way and makes the understanding                        of a rather difficult concept somewhat easier. It is                          however, much longer than the simplistic explanation                          below. The choice of course is yours.                                                                                                                                                                       Ŀ  In reality, if the HIV status of the real patient is not known, an            accident/injury to the health care worker happens AFTER the object (causing   the accident) was in contact with the patient, will cause an almost 100%      transmission to the worker. The reverse of it is not true. If a health care   worker injures self (whether a known or unknown HIV carrier), the health      care worker obeying the rules of sterility or cleanliness, will STOP,         discard the object, change glove and then he or she will continue the         case/activity.                                                                In order for a Worker--> Patient transmission to take place, additional to    an accident, the carelessness of the worker is required (not to stop,         disregard the rules of sterility and cleanliness), continue to use the        object which injured him/her and with that object, transmit the HIV virus     to the patient.                                                               While a one step Patient-->Worker accident, almost 100% of the time will      result in a transmission if the patient is HIV+, the two step                 Worker-->Patient accident should not result in a 100% transmission rate.      