Tandem Masters and HIV

[WeakMindedFool 0]

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I have no a problem with disclosing risk factors and allowing people to choose whether they want to accept that risk or not...
what is the benefit to hiding it?

Elfanie,
I see what you and Jimbo are saying, but, you are informed, you know how difficult is is to transmit HIV. All situations are not the same, as you've said HEP scares the crap out of us, so does TB, HIV doesn't even make me skip a beat now. In 1989 I was terrified of it, had my hands shaking while doing an invasive procedure on an end stage AIDS patient. Why the change now? I know lots of people who have caught TB and Hep B&C. I have never met anyone, or heard of anyone (other then the famous nurse accidentally injecting 10 cc's of tainted blood into her leg) who got AIDS from a patient. That's not to say It has never happened, but it's not the boogie man people are making it out to be. It comes down to weather or not there is a genuine significant increase in risk for the student....is there?
Would the public be served by knowing someones HIV status at the DZ? I think it's been pretty well demonstrated that this person would be treated differently by many. By keeping something to yourself that causes no harm to others is not DISHONORABLE or whatever other buzz word people are using, it's self preservation. Someday we may live in a world where people are safe from intolerance, but we aint there yet!

Faith in a holy cause is to a considerable extent a substitute for lost faith in ourselves.
-Eric Hoffer -
Check out these Videos

[KolinskyDC 0]

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Yes, accidents do happen, and if they do I would hope that the parties involved would be candid and inform those of the risk. If not, they have the right to their privacy.

And what about the "right" of the student to know that if there is an accident, he or she may be exposed to contracting HIV. I honestly can't understand people actually thinking that it is right to withhold this information in this scenario. This is not a discussion about ignorance or social stigma as many have stated, but informing someone of a very real risk that they are taking, regardless of how small the chance of it happening. That is their right to make that decision for themselves and no-one has a right to take that away from them.

And this attitude of well if there is an instance where there is an accident and bodily fluids are exchanged, then tell them you have HIV, so they can go get anti-virals. That is the most ridiculous, selfish thing I have ever heard. I for one would find it very hard to live with myself if I knowingly withheld this kind of information from someone and then passed this disease on to them. That is immoral, there may not be a law regarding it, but in my opinion there should be.

Melissa

"May the best of your past be the worst of your future"

[Jimbo 0]

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And what about the "right" of the student to know that if there is an accident, he or she may be exposed to contracting HIV.

That "right" is apparently trumped by someone's "right" not to have his feelings hurt, or be embarrassed.

-
Jim

"Like" - The modern day comma
Good bye, my friends. You are missed.

[Casquito 0]

How the heck does someone inject 10cc of anything into their leg on accident? It's hard enough to inject anything over 10 or 15 seconds without blowing the needle off the syringe.
Anyway, I think people are getting emotional because of the stigma attached to HIV. I don't see a thread of whether someone should disclose their hepatitis status. Nor their PPD (TB skin test) positive result. Or any other infectious disease. Yet people are upset about this illness which is actually much less fulminant and harder to transmit than the others. Do they realize they are all incurable (maybe TB isn't... but it's damn hard to really cure someone)? Why then is HIV any different? Every argument made on the side of disclosure is a valid one. Yet how is HIV different from Hep B or C? I've yet to hear why HIV should be reported but it would be acceptable not to report hepatitis. It's simply this contradiction that makes it impossible for me to support reporting HIV and not these other diseases. If I should make that distinction, then on what basis? I have no basis other than moral judgements and individual perception. If we report one, we should report all. In theory, I agree we should all know the risks of everything in all aspects of our life, but it's not practical. They don't tell me the risk of brake failure and death when I buy a car, for instance. There is no placard on the crosswalks on my street that state I may be run over by a car or electocuted by a short circuit in the wiring of the button I push. Life is full of risks and we can never know them all.
In my work, I assume every patient is a petri dish teeming with the worst incurable diseases known to man and use universal precautions. The only time I do anything different is if someone has a disease communicable by a respiratory route, in which I put on a mask. But otherwise, I don't even care what someone's HIV, Hepatitis, whatever, status is. I'd still crack their chest and stick my GLOVED hands in there all the same. Simply because I assume everyone is a danger to me and take precautions against it.
Just assume everyone is infectious (they are!) and if you happen to find out someone has HIV, hepatitis, whatever, then you simply confirm what you suspected all along... and prepared for anyway.
Me, I'd jump with a TM with HIV. There are alot more people with other funk (like herpes for example, and hepatitis has MANY more carriers.) yet people don't seem to care. I don't.

[WeakMindedFool 0]

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How the heck does someone inject 10cc of anything into their leg on accident? It's hard enough to inject anything over 10 or 15 seconds without blowing the needle off the syringe.

Let's see...Source is "The Comming Plaugue" by Laurie Garret. It was a very strange but documented situation, RN doing a draw with a syringe (like a 10cc I believe) fell, large bore point into thigh, plunger into ground. I can't remember if she got the full 10cc's...but she got alot.

I'm seeing a trend here, people who are in the field don't seem to care much. People who's primary source of information is the media (that's just a guess all) are alot more excited...I wonder what that means???

Faith in a holy cause is to a considerable extent a substitute for lost faith in ourselves.
-Eric Hoffer -
Check out these Videos

[elfanie 0]

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How the heck does someone inject 10cc of anything into their leg on accident? It's hard enough to inject anything over 10 or 15 seconds without blowing the needle off the syringe.

Not hard at all...depending on the guage of the needle and what you're injecting.

I had to take daily 10CC in oil of progesterone...but we used an 18 guage needle for that and took about 25 seconds to inject it...

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Anyway, I think people are getting emotional because of the stigma attached to HIV. I don't see a thread of whether someone should disclose their hepatitis status. Nor their PPD (TB skin test) positive result. Or any other infectious disease.

(side note: I have said several times "or hepB or any other contageous diseases.." This, to me, is not about HIV...but about health and diseases that can be transmitted..)

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Every argument made on the side of disclosure is a valid one. Yet how is HIV different from Hep B or C? I've yet to hear why HIV should be reported but it would be acceptable not to report hepatitis.

I agree with you...
both should be reported.

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Me, I'd jump with a TM with HIV. There are alot more people with other funk (like herpes for example, and hepatitis has MANY more carriers.) yet people don't seem to care. I don't.

I would jump with an HIV+ TM....sure.
but that should be MY choice. And I was never talking about HIV in particular...I was referring to any contageous non-curable lethal disease...

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Elfanie
My Skydiving Page
Fly Safe - Soft Landings

[ACMESkydiver 0]

I feel disclosure should be necessary both ways...if I had any condition that could jeopardize my instructor or student (if I was a tm) I would feel obligated to let them know the additional risk they are taking.

Stigmas or no, doesn't matter...I would be imposing an additional risk. I feel the disclosure would be just as significant as disclosing untreated Epilepsy, which could injure the tm or myself or both...or any other additional risk.

Those are just my thoughts on it though.

~Jaye
Do not believe that possibly you can escape the reward of your action.

[billvon 2,991]

>Does the student have a right to know that his/her tandem master
>has a terminal, and contagious, disease?

No.

You should tell your student about any significant additional risks your condition/experience poses him. Orthopedic injuries and repairs, alcohol and drug usage over the past week, time since last tandem, number of tandem malfunctions and the amount of rig inspection you have done prior to donning the rig have FAR more to do with the potential of injury or death on the jump than being HIV positive does. So unless you do all that as well (and I have never seen a TM do all that) adding HIV or hepatitis information does not significantly increase the student's awareness of the risks of the jump.

People are afraid of HIV, no doubt about that. It's a scary disease. You are far more likely to die on a tandem because your JM did not check the reserve pins or the RSL than because he is HIV and you had some sort of accident that resulted in an injection of his blood into your body. That has never happened, whereas gear problems, JM inexperience or error, and JM impairment from alcohol/drugs have happened with some regularity. Issues that affect that are therefore more relevant and should be presented to the student before you get to imaginary risks like HIV transmission.

[ltdiver 3]

Just a simple question, Melissa.

In Chiropractic circles, would a practitioner still treat someone who'd disclosed they were HIV+? What about with active AIDS?

ltdiver

Don't tell me the sky's the limit when there are footprints on the moon

[KolinskyDC 0]

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Just a simple question, Melissa.

In Chiropractic circles, would a practitioner still treat someone who'd disclosed they were HIV+? What about with active AIDS?

ltdiver

That would depend on the individual practitioner. I personally would and have treated both and know many chiropractors that have as well, but that was my decision to make. I also stated earlier in the original thread posted by deadboy2004 that I would have no problem doing a tandem with him, but would expect to be told about the possible risk of exposure prior to making that decision?

I am not sure if I am allowed by law to refuse chiropractic care to a patient because they are HIV+, only because it never crossed my mind to not care for them. Actually I wish I had more HIV+ patients. Chiropractic is proven to have positive effects on the immune system, in turn improving the overall health of the patient.

I am not sure where you were going with that question. With giving an adjustment, there is virtually no risk of exchanging bodily fluids (at least those fluids that can transmit HIV) but when you are such a close proximity to another human (as with a tandem) and if there is an accident, there is a very real risk of exchanging blood, regardless of how small that risk is, it is still present and I feel that a person (whether it be the student or the instructor) has the right to know of this risk.

Melissa

"May the best of your past be the worst of your future"

[piisfish 140]

I voted no. If he asked though, he is in right to be informed.

scissors beat paper, paper beat rock, rock beat wingsuit - KarlM

[Ron 10]

Yes. Anything that could kill you...should be talked about.

While it would be a very small chance of an injury that woud allow the blood to mix...It COULD happen.

This is a sport that sometimes breaks people.

Billvon jumped on my case once I think for going to a femur break without gloves....I had em, but he was right.

So if Im not supposed to rush out to a broken jumper without protection,..why whould I want to risk being strapped to him in the event of a crash?

Simple I would not.

As for the sign that says I have had sex with 60 women...Hell, I'd wear it with pride

"No free man shall ever be debarred the use of arms." -- Thomas Jefferson, Thomas Jefferson Papers, 334

[elfanie 0]

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Billvon jumped on my case once I think for going to a femur break without gloves....I had em, but he was right.

So if Im not supposed to rush out to a broken jumper without protection,..why whould I want to risk being strapped to him in the event of a crash?

Simple I would not.

Not that I would ever presume to speak for Bill....however...

Not going out to a femur break without gloves...that should be the same regardless of whether or not you know that person has HIV, Hep, or anything else. Even if the person said explicitely, "I do not have HIV or Hepatitis.." you should still be yelled at for attending to an open wound without gloves. That's what Universal Precautions are for...and they don't require disclosure on the part of the victim.

So you say,

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So if Im not supposed to rush out to a broken jumper without protection,..why whould I want to risk being strapped to him in the event of a crash?

then you shouldn't do any tandem jumps...period. Universal precautions means you treat everyone as if infected without prejudice. According to the statement above...you shouldn't do any tandem jumps ever.
Do you HONESTLY believe that everyone you've been strapped to is without illness? And that everyone who has HIV or hepatitis knows about it?

If you were smart...you'd never attend to an open wound without gloves on anyone but your spouse, your children, and your other immediate family members.

Universal precautions means EVERYONE is treated as contageous...to do otherwise is unsafe.

--------------------------------------------
Elfanie
My Skydiving Page
Fly Safe - Soft Landings

[Ron 10]

#1. I had gloves. But he didn't know I had them.

And it is wrong to know you have a fatal disease and not tell the people that could be in a situation that could cause it to be transmited to another.

And before a bunch of people start yelling I don't know what I am talking about, and I get my info from the news...

I have been trained in spill clean up for over 7 years...And that includes bloodborne pathogens. It was my primary job for 2 years.

"No free man shall ever be debarred the use of arms." -- Thomas Jefferson, Thomas Jefferson Papers, 334

[elfanie 0]

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#1. I had gloves. But he didn't know I had them.

And it is wrong to know you have a fatal disease and not tell the people that could be in a situation that could cause it to be transmited to another.

the morality of disclosure wasn't the issue I was responding to and wasn't the point I was making with you...

if you know so much about universal precautions, then you know that they apply regardless of whether you beleive you know the status of the victim or not. You don't choose to wear gloves only because they told you they had a disease....you wear them ALWAYS, even if they tell you they don't have anything.

Bringing that over to being a TM....if you wouldn't jump with someone who disclosed, then you shouldn't jump with someone who didn't. Universal precautions. If you wouldn't jump with someone just because they have HIV....then you shouldn't be jumping with everyone.
(in this comparison - not jumping tandem with someone is equal to wearing gloves. It's an action taken in the event of a disease present to protect yourself from the risk that disease presents. If you use universal precautions, then - IF you wouldn't take an HIV person on a tandem, THEN you shouldn't take anyone on a tandem. IF you wouldn't tend to an open wound on someone with HIV without gloves, THEN you shouldn't attend to anyone's wound without gloves....)


Universal precautions states that you treat everyone as if they have an infectious disease...
wouldn't jump with an HIV+ person? Then you shouldn't jump with anyone.

The morality of disclosure is a different issue altogether.

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Elfanie
My Skydiving Page
Fly Safe - Soft Landings

[KolinskyDC 0]

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Universal precautions states that you treat everyone as if they have an infectious disease...
wouldn't jump with an HIV+ person? Then you shouldn't jump with anyone.

I disagree, and with this line of reasoning then if you would not have sex with someone who is HIV+, then you should not have sex with anyone. Each scenario must be examined in it's own light.

Melissa

"May the best of your past be the worst of your future"

[elfanie 0]

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I disagree, and with this line of reasoning then if you would not have sex with someone who is HIV+, then you should not have sex with anyone. Each scenario must be examined in it's own light.

Melissa

Yup...that's correct. If you wouldn't have sex (unprotected) with someone who is HIV+...then you shouldn't have unprotected sex with anyone...

the exemption to this is if you know that they have been tested...are in a monogamous relationship...and have decided to put your life on the line for them.

that's how they become a "spouse, children, or other close family members".

If he said that he would only take close friends/family on a tandem but nobody else....that would still be understandable.
If he says that he wouldn't take an HIV+ person on a tandem, but that he'd take a stranger who simply said he wasn't HIV+ on a tandem...that's on the verge of silly.

if you wouldn't have sex with an HIV+ person...then should you come across a stranger who wants to have sex with you - even if they say they are clean, you should still say no (or protect yourself like you would against an HIV+ person.)

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Elfanie
My Skydiving Page
Fly Safe - Soft Landings

[goose491 0]

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Universal precautions states that you treat everyone as if they have an infectious disease...

And that's a wonderful practice for those who deal with the wounded or perform open surgery on a regular basis. The Universal protection is there to save you from having to decipher the risk yourself. It is there to save you having to ask. It is there because the person you are helping may not be coherrant or even able to answer. It is there because the person you are helping may not even know if they are infected with something contagious.

Skydiving is a little different don't you think? Yes, boxers DO have to disclose contagious deseases and Yes, other boxers DO have the right to turn down a fight based on this.

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wouldn't jump with an HIV+ person? Then you shouldn't jump with anyone.

That's retarded. Doing a tandem is not performing surgery or tending to an open wound... but the possiblility of there being an injury to both parties and of the blood mixing is there. I'm not a tandem master, I've never been a tandem passenger.

But I voted yes. There is a new risk presented to freefall when you are strapped to another person. There is yet another one presented when that person contains blood that could infect you should you be exposed to it. Every single person on each and every load should understand every risk involved with the jump they are about to make. Universal protection is great... but should the one that does not accept the additional risk of contracting something on this jump really be told "Fine, then you shouldn't ever jump with anyone." ?

My Karma ran over my Dogma!!!

[WeakMindedFool 0]

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And that's a wonderful practice for those who deal with the wounded or perform open surgery on a regular basis. The Universal protection is there to save you from having to decipher the risk yourself. It is there to save you having to ask. It is there because the person you are helping may not be coherrant or even able to answer. It is there because the person you are helping may not even know if they are infected with something contagious.

This is incorrect. Our exposure is higher, and ironically this makes us less likely to get most things, but the reason for universal precautions is to reduce possible opportunities to contract pathogen. It makes NO assumption about the person you are working on, alive, dead, whether they are up front about their medical history or not. The risk has been assessed, make no mistake, and that assessment is not for HIV or HEP alone but for a broad range of things in BOTH directions. I am more likely to infect a full blown AIDS patient with VRE or MRSA from my last patient (yes we clean up but staph is hard to kill. The best decon is imperfect) then from contracting HIV from him.

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That's retarded.

Did you really need to say this?

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Doing a tandem is not performing surgery or tending to an open wound... but the possiblility of there being an injury to both parties and of the blood mixing is there.

Please cite one case of a casual transmission of HIV (please exclude the "Bel Glade Study" as I know virologist who worked on it and they were full of shit. Following studies proved that they were wrong) hell I doubt you can produce an exaple of wound to wound transmission. HIV requires an injection of virus (Sharing needles with blood in them (junkies draw back on the syringe to insure they are in a vein before they push, contaminating the syringe in an air tight environment) blood transfussion or sex). None of the conceivable scenarios in a tandem accident will support the required injection of virus from one injured party to another (for HIV). If you want to talk about what to be cautious of, Hep can live in dried blood for a week so if you get dried blood (from a contaminated suit, falling on the same spot someone who was injured) in a wound, you can get it. As for TB, viable virus has been found in the lungs of egyptian mummies. If you wish to go down the road of disclosure of medical history at the DZ at least know what it is you should be afraid of.

Faith in a holy cause is to a considerable extent a substitute for lost faith in ourselves.
-Eric Hoffer -
Check out these Videos

[jlmiracle 7]

I think this is a question for every jumper, not just TM.

Just think of how many times jumpers get hurt and who are the first people to help them, we are.

Should all jumpers be required to disclose to the DZ if they have a contagious disease? Should it be part of waiver?

I don't really know how to answer the question(s). Because I think I have a pretty good understanding on how one contracts HIV, but I also know how ignorant some people are and would treat that person differently.

Its a tough question.

Judy

Be kinder than necessary because everyone you meet is fighting some kind of battle.

[dgskydive 0]

Touchy subject here for sure.

I don't know everything about this stuff, but I would think you would want to let the other person know and vice versa.

In the case of HIV. I have seen someone catch it because they weren't told that someone else had it.

An ex girlfriend of mine got it from having unprotected sex with a guy that was HIV positive and he didn't tell her. The last time I checked the talk was of charging him with attempted manslaughter. I know this is a bit different of a situation that we are talking about here.

The thing that gets me about the situation other then the obvious sadness I had for the girl and how her life was now ruined. Was that this happened while I was in the Army. We are put into situations everyday that put us at additional risk and had no idea. I would have liked to know the extra risk I would have been taking if I had to give first aid to this guy. Sure, I would have worn gloves but they may not have been available at the time. If they weren't I at least would have been able to make an in formed choice before potentially getting it myself. For the record I don't know wha tI would have done if that situation had come up.

Now as a student or TM or in any walk of life. If you have a disease, I think you should disclose it to anyone that has a reasonable chance of catching it from you. I think in skydiving there is a reasonable chance that it could be transmitted if an accident occured. Therefore it should be disclosed.

Dom

[Liemberg 0]

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I have been trained in spill clean up for over 7 years...And that includes bloodborne pathogens. It was my primary job for 2 years.

The inevitable $64000 question is of course:

Would you jump with a passenger that
1. Is HIV+ ? or
2. You suspect of being HIV+? or
3. Might be HIV+?

Do you / does your DZ interview potential passengers about their status in this respect?

(If your blood might be mixed with mine, then the same goes the other way around, doesn't it?)

There is a difference between tandems and unprotected sex - in case you haven't noticed...

"Whoever in discussion adduces authority uses not intellect but memory." - Leonardo da Vinci
A thousand words...

[billvon 2,991]

>If you have a disease, I think you should disclose it to anyone that
> has a reasonable chance of catching it from you. I think in skydiving
> there is a reasonable chance that it could be transmitted if an
> accident occured. Therefore it should be disclosed.

If you do that, you are morally obligated to inform him of all the greater risks to his health. (It would surely be irresponsible to inform him of the imaginary risks to his life, but not inform him of the risks that have been proven real.) That includes the last time you drank or did drugs and the amount. It would also include any orthopedic injuries you've had, your most recent tandem, when you repacked the main last (or which rigger did) and the amount of inspection you did on the gear before putting it on. And of course you'd have to tell him the number of jumps on the main and reserve, and how old the tandem system was.

Until I hear people making those kind of disclosures - disclosures of conditions that have, in the past, caused problems, injuries, and fatalities of tandem students - I can't believe that warning someone of a completely imaginary risk is all that important.

[Jimbo 0]

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I can't believe that warning someone of a completely imaginary risk is all that important.

Bill, in the case of a contagious, and terminal disease, the risk is not imaginary. The risk of transmission may be low, but it's not imaginary. I already know that skydiving is dangerous, the DZ did a pretty good job at communicating that. Why should my right to evaluate the -additional- risk be compromised? To spare someone's feelings?

-
Jim

"Like" - The modern day comma
Good bye, my friends. You are missed.

[elfanie 0]

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I can't believe that warning someone of a completely imaginary risk is all that important.

Bill, in the case of a contagious, and terminal disease, the risk is not imaginary. The risk of transmission may be low, but it's not imaginary. I already know that skydiving is dangerous, the DZ did a pretty good job at communicating that. Why should my right to evaluate the -additional- risk be compromised? To spare someone's feelings?

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Jim

He's not saying that you don't have the right to evaluate risk...
he's saying (sorry bill) that if you are wanting to have the right to evaluate risk, then start at the top. Evaluate your risk of death from the canopy not opening...what can go wrong with canopies. Then evaluate your risk of death from the landing...what can go wrong with the landing. Evaluate your risk from opening shock..from freefall....

that's one group of risks,a nd it's usually covered.

Now lets focus on how YOU make it more dangerous...the risks involved with having YOU as the TM. How many tandems have you done? when was the last one? etc etc (Bill's list)
those things pose imminently more risk to the tandem student than your HIV status. NOBODY yet has died from HIV they contracted from a tandem skydive...nobody. people HAVE died from other things like not being current or having canopy issues...

He's saying that there are times when the risk is so teeny tiny...that there are larger issues we shoudl focus on if we want to be effective at establishing risk factors.

Instead of asking a person who is selling a car whether they ever had anyone with HIV bleed in their car...you should probably focus on when the brakes were last done, if the car has been in any serious crashes, if the air bags work properly, how the steering is...all of the things that post a true and imminent risk to yourself.
leave the petty little nitpicky items for when you have all of the bigger issues already covered and still have time on your hands.

(if I'm misunderstanding you, Bill...please feel free to correct me)

--------------------------------------------
Elfanie
My Skydiving Page
Fly Safe - Soft Landings