Universal precautions are a set of rules to protect health care workers from certain infectious diseases. Included among those diseases are HIV infection, hepatitis, and any other infectious disease transmitted through body fluids (blood, saliva, urine). All hospitals in the United States are required to practice universal precautions.     Though the rules of universal precaution apply to all body fluids, the major concern is for blood and bloody fluids. The rules require a barrier between the health care worker and the fluid. The barrier rule means that gloves are to be worn when obtaining blood samples or dressing wounds and the like. Goggles, face shields, or similar devices may be used during procedures (like childbirth) that may result in splattering of blood. Hospital gowns must be worn when clothes might be soiled. For such day-today care as taking temperatures and blood pressure, no gloves or other barriers need be used.     It should be emphasized that universal precautions are universal. They apply to all people participating in the care of any patient in the hospital. There are no precautions that are special to people with HIV infection. Exceptions are the opportunistic infections—like salmonella, tuberculosis, and shingles—that pose a threat to health care workers. But these infections require the same precautions regardless of HIV status.*168\191\2*

Some of the best support for people affected by HIV infection comes through organized support and therapy groups. People often resist joining such groups because, they say, their families and friends and religion are sufficient, or they are embarrassed to turn to strangers, or they just don’t like joining groups. Once they join a group, however, they find that talking to people who share the same experiences allows them to open up and say things they could not otherwise say. For people whose family and friends are unable to be much help, support and therapy groups are lifesavers.     Talking to people who share your situation can reduce your sense of isolation and give you a feeling of community. Listening to them talk can also give you a different perspective on your own problems. Seeing what works for other people and what does not helps you decide what might work for you. Hearing your problems described by someone else as their problems is somehow reassuring, calming—you don’t feel alone with your problems; you’re in good company. People say that groups give them a sense of relief from their own problems, and a sense of hope. People like the thought that they might be helping others in their group.     Support and therapy groups are found everywhere hospitals, clinics, churches, AIDS-advocacy organizations, to name a few. Groups are composed of people with common situations. Some groups are for people who have the virus but no symptoms; some are for people with ARC, some for people with AIDS; some are for caregivers; some are for the people with AIDS and their caregivers; some are for women with AIDS; some are for black men with AIDS; some are for gay men; some are for intravenous drug users.     Though the difference between support and therapy groups is not always clear-cut, support groups tend to be for company and comfort, therapy groups for solving specific problems. The goals of support groups often include learning to reduce isolation, to share experiences, to see what works for others, to express things you might not express elsewhere, to feel accepted. Those who choose a support group are principally looking for a safe place in which to be themselves and to be less isolated. The goals of therapy groups are the same, but also include learning to confront negative patterns. Those who choose a therapy group worry about patterns in their lives with which they are unhappy: they feel they are always lonely, for instance, or that they pick the wrong sorts of partners. These are not necessarily problems specific to HIV infection, though everyone else in the group should also be dealing with HIV infection.     Both types of groups should be small, usually from five to eight people. Both groups are usually led, more or less loosely, by a qualified, experienced mental health professional. Mental health professionals say that what kind of group you get into is less important than getting into a group in the first place. Alan began going to a support group when his counselor recommended it: “The group has had a big effect on me. One of the worst things about the virus is not talking about it. When I talk to the group, my feeling of isolation is gone. The group also helps me release stress and anger. Plus you get a perspective on HIV, that it’s no big thing, though I’m logical enough to know it is a big thing. But the perspective helps me not paralyze myself and not get into self-fulfilling prophecies. The group has been such a support.”     Steven found that his group helped him feel hope and courage: “It’s uplifting at the meetings. You get encouraged to keep trying to find help, to pursue all avenues. You learn that someone is out there no matter how bad it is. You learn you’re entitled to help.”     Support groups help people understand themselves better and find connections with other people. “Sometimes, when you finally verbalize the things that are pretty far down,” Alan said, “they become a permanent part of you. I have always felt pretty isolated, and I was able to say that. One time the group leader said that we will realize the people we love, love us. I found some people who love me that I hadn’t even realized did love me. That opens me up to a nonsexual loving relationship.”*234\191\2*