Issue link: https://www.massageandbodyworkdigital.com/i/841282
safe for them to be exposed to our transient bacteria, or if our client is using some medication that is excreted through the skin. But none of these scenarios describe a typical person who is HIV positive. If both parties in a massage therapy session—the therapist and the client—have skin that is healthy and intact, there is absolutely no reason to use gloves during a massage. If one person has compromised skin, then that area must be covered and avoided during the massage. How is this guideline different for clients who are HIV positive compared to others? That's a trick question: it isn't. HOW THINGS HAVE CHANGED—FOR THE BETTER! It's been a journey to watch how HIV went from being completely unknown, to being a huge public health scare with enormous social and political repercussions, to being a chronic, serious, but manageable disease. The stigma and sense of judgment against people with AIDS has also lessened, but it is certainly not gone entirely—the myths that prompted this article are living proof of that. People who are HIV positive are advised to stay as healthy as possible—to exercise, eat carefully, and to seek out healthy, supportive relationships. And, if everything goes well for them, they have a chance at a long and fruitful life. Obviously, this depends on access to good health care and the appropriate medications, which is not a given, since these meds can cost $20,000 or more per year. Massage therapy won't solve the problem of access to health care for HIV-positive patients, but we can be part of a supportive and nurturing network of caregivers. We are in a unique position to offer caring, educated, and nonjudgmental touch. Our work has been seen to reduce symptoms of depression and anxiety, to improve sleep and lessen fatigue, and to help reestablish a sense of self-efficacy or the sense of being able to cope with life's stressors. When it comes to HIV and AIDS, our profession has a lot to bring to the table. I encourage us to pursue those good outcomes with great passion and even greater compassion. Ruth Werner, BCTMB, is a former massage therapist, a writer, and an NCBTMB-approved provider of continuing education. She wrote A Massage Therapist's Guide to Pathology (Lippincott Williams & Wilkins, 2016), now in its sixth edition, which is used in massage schools worldwide. Werner is available at www.ruthwerner.com. remember, about 13 percent of all HIV-positive people in the United States don't know they are infected.) We change our sheets, swab our surfaces, and wash our hands consistently, because every client who comes through our door could have some unwelcome passengers. If we are conscientious about this, our risk of exposure to HIV in legitimate massage settings is essentially zero. Indeed, our risk of exposure to hepatitis B or C is much greater than the risk of HIV infection, since these hepatitis viruses can be spread through casual and indirect contact. But as a culture, we seem to be much less concerned about potentially life-threatening liver infections than we are about HIV or AIDS. And here's the other thing: we can ask much more useful questions than, "Do you have HIV?" Here are three: • Do you have any chronic infections? • What medications do you take? • What side effects do these medications cause for you? These questions do not force a distinction between HIV and other chronic infections, and the questions about medications and side effects will help us determine our best strategies for the client much more efficiently than getting to this information in any other way. MYTH MTs SHOULD WEAR GLOVES TO WORK WITH HIV-POSITIVE CLIENTS When a massage therapist consults the Internet about working with clients who are HIV positive, one of the frequently offered suggestions is that we should wear gloves when working with this population. First, why are you looking for this kind of guidance online? Do you not own a good pathology book? I can make a couple of suggestions (hint-hint). And second, gloves— really? Why? For what reason? What is the risk? When we practice basic hygienic precautions, we create an environment where anything that one client touches is cleaned or replaced before another client touches it, and we do this for every client. This doesn't only limit the spread of HIV, it also helps us limit the spread of other much more common and sturdy viruses like cold, flu, hepatitis, and herpes. It is appropriate to wear gloves in some circumstances—like if we have open lesions on our hands that can't be covered more locally, or if our client is so immune-compromised that it wouldn't be C h e c k o u t A B M P 's l a t e s t n e w s a n d b l o g p o s t s . Av a i l a b l e a t w w w. a b m p . c o m . 59