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Routine preoperative screening for human immunodeficiency virus in a general hospital, Saudi Arabia.

Published data suggest that surgeons experience intraoperative skin penetration once every 40 cases. A 1-year trial of routine preoperative patient screening for HIV antibodies was started in October 1991 at King Khalid National Guard Hospital (KKNGH) in Jeddah. At the same time a prospective study was launched to determine whether there were benefits to the screening program. 65% of patients seen at KKNGH are Saudi the rest are expatriate. 5 of the 6739 patients who underwent surgery at the hospital from October 1991 to October 1992 were infected with HIV. 4 of those 5 would have been suspected to be HIV-positive based upon their medical histories and clinically indicated tests. The actual cost for the routine preoperative HIV screening in 1992 US dollars was $101 per test or $680639 for all patients evaluated over the course of the year. This study found some evidence that routine screening for HIV infection may induce a false sense of security among surgeons leading to a relaxation of Universal Precautions. The authors recommend the discontinuation of the screening program at KKNGH instead testing only high-risk patients.