Of hair clippers and HIV infection

Going to the barber? What are the thoughts running through your mind? Hoping the appointment will not take up all your lunch break? Yes. Hoping there will be no extra charge for using mobile money to pay? Yes, especially if you are in Zimbabwe today. Hoping the water will be warm? Yes.

Calculating the risk of you contracting HIV or Hepatitis B from that salon visit? Absolutely not.

Researched by Lifaqane Nare

Unless you have read The Chronicle of April 12, 2018, with the headline: BARBER SHOPS POSE HIV RISK. . . National Aids Council issues chilling warning

Claim: People who have their hair cut at salons are at a high risk of contracting HIV through sharing barber clippers, the National AIDS Council has warned.

Conclusion: Incorrect

This claim was said to be corroborating findings from a report that has been published following a study carried out by the Hair and Skin Research Laboratory at the University of Cape Town in South Africa, led by Prof Nonhlanhla Khumalo.

Findings of the Study

The objective of the study was to investigate the prevalence of barber hair clipper contamination with blood, HIV and hepatitis B viruses.

To do this, fifty barbers from three townships in Cape Town were invited to participate. One clipper from each barber was collected immediately after it had been used for a clean-shave haircut.

The conclusion from the study was that there is significant contamination of barber hair clippers with blood and blood-borne viruses, with 42% of the clippers contaminated.

Hepatitis B was detected with enough DNA copies to pose a risk of transmitting infection.

(Blood and virus detection on barber clippers. Available from: https://www.researchgate.net/publication/324344773_Blood_and_virus_detection_on_barber_clippers [accessed Apr 19 2018]).

Zimbabwe’s HIV prevalence has declined from a peak of 29 percent in 1999 to 14.5 percent in 2016, according to UNAIDS data

HIV infections in Zimbabwe

Zimbabwe’s HIV prevalence rate peaked at 29% in 1999 and decreased to 14.5% by 2016, with 1.3 million people living with HIV.

According to UNAIDS, Zimbabwe had 40000 new HIV infections and 30 000 AIDS-related deaths in 2016. However, since 2010, new infections have decreased by 49% and AIDS-related deaths by 45%.

This has been attributed to strategies that have included prevention methods such as practicing safe sex, sticking to one partner and knowing one’s status, among others.

Can unsterilized hair clippers infect people with HIV?

Director of the AIDS and Tuberculosis unit in the Ministry of Health and Child Care, Dr. Owen Mugurungi, says the risk of contracting HIV with sharp instruments is high, especially when there is a cut.

“Some 20 years ago we warned people about the risk of transmitting HIV through razor blades and barber equipment and we took a decision that people sterilize using alcohol and now most barber shops use spirit to sterilize their equipment,” he says.

Mugurungi says there have not been studies on the exact time the virus survives outside the body but says “for HIV to survive outside the human body it has to be in the blood or body fluids. It will survive until that blood or body fluid dries.”

The United States’ Centre for Disease Control (CDC) says HIV does not survive long outside the human body (such as on surfaces), and it cannot reproduce outside a human host. The CDC, however, does not specify how long the virus can survive in those conditions.

Rudimentary structures housing ‘barber shops’ offer services to several Zimbabweans

A 2003 review conducted by Australia’s Sexual Health and Blood-borne Virus Program, Communicable Diseases Control Branch – focusing on discarded syringes – concluded that:

Hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) can all survive outside the human body for several weeks, with virus survival influenced by virus titer (load), volume of blood, ambient temperature, exposure to sunlight and humidity. HBV has the highest virus titers in untreated individuals and is viable for the most prolonged periods in needle syringes stored at room temperature. However, prevalence of HBV and HIV are only 1-2% within the Australian IDU (injecting drug users) population. In contrast, prevalence of HCV is 50-60% among Australian IDUs and virus survival in needle syringes has been documented for prolonged periods. There have been no published cases of blood-borne virus transmission following community needlestick injury in Australia.

A 1991 laboratory study by Enock Tjotta et al, ‘Survival of HIV‐1 activity after disinfection, temperature and pH changes, or drying’ published by the Journal of Medical Virology, established that levels of virus remain relatively stable in blood at room temperature, and HIV may persist for at least a week in dried blood at 4°C. Blood containing HIV used for laboratory experiments is stored at –70°C without any loss of viral activity, the study found.

However, it also established that HIV is very sensitive to changes in alkalinity or acidity – pH level – with pH levels below 7 or above 8 being unsuitable for the long-term survival of HIV.

On the efficacy of disinfectants, the study found that:

“A solution of iodine and detergent (2% Jodopax) was the only disinfectant examined which removed all detectable HIV1 activity. Isopropanol and ethanol were more potent than acetone; however, all three solvents left some viable particles after a 30 min treatment with 70% solutions.”

According to the CDC, Hepatitis B is up to 100 times more infectious than HIV and takes more effort to sterilize and kill than HIV when it’s outside the human body.

“Sterilization has to be more intense,” says Mugurungi.

Mugurungi encourages people to take their own hair clippers to the barbershop, if possible, to reduce the risk of using hair clippers which they do not know if they are sterilized or not.

Mugurungi says there is need for greater awareness of risks of HIV infection in the informal industries like barbershops.

Conclusion

The claim from the National AIDS Council as published through The Chronicle is incorrect in so far as it is based on the research carried out by the University of Cape Town.

The findings of that particular research were that 42% of the hair clippers tested positive for blood contamination. Of those, 4% tested positive for Hepatitis B virus and none tested positive for HIV.

However, this is a major public health issue and there is need for more and bigger studies to be carried out to quantify the risk of HIV infection in barbershops.

In the meantime, treat your hair clippers as you would your toothbrush: Carry your own and do not share.

 

 

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