800.001 Standard Precautions Preventing the Spread of HIV, Tuberculosis, and Hepatitis B in Employees of HIV/STD Funded Programs

Policy Number 800.001
Effective Date March 17, 1997
Revision Date November 20, 2002
Approval Authority TB/HIV/STD Section Director

1.0 Purpose

The purpose of this policy is to support the implementation of infection control measures and the use of standard precautions within programs operated by the Texas Department of State Health Services (DSHS), TB/HIV/STD Section (Section). The precautions are needed to help prevent the spread of communicable diseases, namely the human immunodeficiency virus (HIV), tuberculosis (TB) and Hepatitis B.

2.0 Background

Section staff and applicable contractors provide services to individuals who may be susceptible to diseases which are often transmitted to, and from, individuals with weak immune systems. These diseases pose a threat to the health and safety of Section staff or contractors who provide direct care.

3.0 Authority

U.S. Department of Health and Human Services Guidelines for Prevention of Transmission of Human Immunodeficiency Virus and Hepatitis B Virus to Health-Care and Public-Safety Workers. Health and Safety Code, Chapter 85, Subchapter Il, §85.201-§85.206; Infection Control Manual for Ambulatory Care Clinics published by the DSHS.

4.0 Adoption of Universal Clinical Precautions

With this policy, the Section adopts the procedures in the most current Infection Control Manual for Ambulatory Care Clinics as the standard by which Section staff, contractors and subcontractors will initiate and maintain standard clinical precautions. The standard precautions should be followed when providing services to persons whose immune system may be compromised due to HIV infection. These persons are at greater risk of infections by communicable diseases such as tuberculosis or Hepatitis B.

5.0 Employee Health Problems

Section contractors are required to develop policy or procedures to describe the methods by which organizations will protect employee health, especially organizations providing clinical services. The following sections detail the requirements of such policy or procedures.

5.1 Minimize the risks of exposure

Contracting agencies will adopt as standard practice the control measures found in the DSHS infection control manual to minimize the risk of exposing employees to communicable diseases, namely HIV, TB, and Hepatitis B.

5.2 Initiate protective measures

Employers are responsible for informing employees and job applicants of their risk of exposure to a communicable disease and for providing protective equipment to employees when an exposure is possible in the workplace.

The Section requires that contractors initiate the minimum requirements of the DSHS infection control manual found below (TABLE A.) when employees may be exposed to blood or other body fluids. The intent of citing these specific actions from the DSHS infection control manual is to emphasize the Unit's expectations, not to substitute for the DSHS infection control manual. Should the DSHS infection control manual be revised, contractors and staff will be expected to follow the revised standards.

Table A.

Joint Advisory Notice Category*

Nature of Risk, Task or Activity

Personal protective equipment should be:



I. Direct contact with blood or other body fluids, or close contact with clients who may be infected. Yes Yes
II. Activity performed without blood or bodily fluid exposure or close contact with clients who may be infected, but exposure may occur in an emergency. Yes No
III. Task/activity does not entail predictable or unpredictable exposure to blood or close contact with clients who may be infected. No No

* U.S. Department of Labor, U.S. Department of Health and Human Services. Joint advisory notice: Protection against occupational exposure to Hepatitis B virus and human immunodeficiency virus (HIV), Washington, D.C.: U.S. Department of Labor, U.S. Department of Health and Human Services, 1987.

5.3 Screen for tuberculosis

  • Provide screening for all employees. Employers should consult with a local health department or clinical provider to obtain more information on tuberculin skin testing.
  • Tuberculosis screening and immunization activities must be performed by a licensed physician or by someone acting under direct, written delegation/orders from a licensed physician.
  • Follow up on employees who have a positive reaction to the test. Provide positive reactors with referrals to the local health department or a clinical provider for medical evaluation.

5.4 Immunize against Hepatitis B

  • Make Hepatitis B vaccine available to staff at risk of exposure in categories I and II (TABLE A.). Employers should consult with a local health department or clinical provider to obtain more information on immunizing for Hepatitis B.
  • Require employees who have been vaccinated to show proof of a Hepatitis B vaccination series or serologic evidence of immunity.

6.0 Costs Associated With the Delivery of This Policy

Grant funds may be used to pay for TB screening and for Hepatitis B vaccine for employees who are at risk of exposure to these diseases in the performance of their duties. The costs are allowable under the contract and may be charged to medical supplies provided private health insurance will not cover the service or other funding sources are not available.

Contractors may consider contacting the DSHS Immunization Unit at 512-458-7284 or toll free 800-252-9152 for assistance in purchasing the Hepatitis B vaccine.

7.0 Revision History

Date Action Section
9/1/2017 Changed "TB/HIV/STD Unit" to "TB/HIV/STD Section" to reflect new program designation -
9/24/2014 Converted format (Word to HTML) -
12/30/2002 Changed “universal” to “standard” in policy title and throughout All