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HIV Risk Assessment Stratification Protocol

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HIV Risk Assessment Stratification Protocol, RASP Score

  • See Also
  1. Needlestick Injury
  2. HIV Exposure
  • Indications
  1. Quantify HIV risk associated with Needle Stick in healthcare providers
  • Precautions
  1. Non-validated and initially created in 2003
  2. Does not include viral load data in decision making
    1. Undetectable viral load virtually eliminates risk from Needlestick Injury
  • Criteria
  • Source Population (A)
  1. Score +1: Known HIV positive AND Acute AIDS Illness
  2. Score +10: Known HIV positive AND Asymptomatic HIV
  3. Score +100: Unknown HIV status AND high-risk situation
  4. Score +1000: Unknown HIV status AND low-risk situation
  • Criteria
  • Inoculum Type (B)
  1. Score +1: Fresh Blood
  2. Score +10: Other high risk fluid (e.g. semen)
  3. Score +100: Dried old blood
  4. Score +1000: Low risk secretions (e.g. tears, urine, Saliva)
  • Criteria
  • Method of Transmission (C)
  1. Score +1: Intravenous
  2. Score +10: Deep intramuscular
  3. Score +100: Deep transcutaneous with visible bleeding
  4. Score +200: Superficial transcutaneous without bleeding
  5. Score +500: Mucosal contact only
  6. Score +1000: Intact skin
  • Criteria
  • Volume of Inoculum (D)
  1. Score +100: Massive (e.g. transfusion)
  2. Score +10: Measurable (>1ml)
  3. Score +5: Moderate (large bore hollow needle >22 gauge)
  4. Score +3: Small (Small bore hollow needle <22 gauge)
  5. Score +1: Trace surface only (e.g. Suture Needle)
  • Interpretation
  1. Total Score (Z) = A * B * C
  2. Basic Risk = 1/Z
  3. Total Risk = Basic Risk * D
  • References
  1. Swaminathan and Habboushe in Herbert (2019) EM:Rap 19(9): 12-3
  2. Vertesi (2003) CJEM 5(1):46-8 [PubMed]