General principles

As in disinfection against any other germ, five basic steps need to be borne in mind in any HIV-related disinfection process:

• Wearing protective clothing and using protective devices.
• Physical cleaning: always make sure surfaces are clear of visible contamination. This needs to be effective because organic material provides a safe place for HIV. It blocks heat getting in and inactivates chemical disinfectants by reacting with them. So you have to be thorough to shift dried semen, blood, faeces, vaginal fluids etc.
• Heat or chemical treatment: follow recommended guidelines. Autoclaving is still the recommended means of sterilising most re-usable equipment. In some cases other specialised methods are necessary. For instance, ethylene oxide should be used to sterilise lensed instruments such as endoscopes or bronchoscopes.
• Careful disposal of contaminated materials and sharps.
• Reporting of any problems, concerns or incidents to your supervisor or adviser.

Domestic disinfection

• Clean up.
• Wear rubber gloves.
• Soak up any large spillages with absorbent paper or cloths which you then wrap up in plastic bags and throw away.
• Next give the spill a first going over with hot water and detergent.

Once you've cleared up all the visible blood or other organic material use a chemical disinfectant such as:

• Household bleach.
• Milton Fluid for cleaning babies' bottles (active ingredient 1.1% available chlorine)Boots' double strength Feeding Bottle Sterilising Fluid (active ingredient 2% available chlorine).
• Maws Simple Sterilising Tablets (active ingredient Sodium Dichloroisocyanurate) are very easy to use since you simply add a 500mg tablet to four pints of water (it is also available as granules which can be used to absorb any spillages of blood).
• Leave the disinfection fluid on the surface for as long as possible.

Dealing with sharps at home

If you need to use needles or Hickman lines (Hickman is a registered trademark of CR Bard Inc.) etc. at home, get hold of sharps boxes and yellow bags for safe collection and incineration.

Social workers or home care teams should be able to arrange this for you.

Laundry

A washing machine with a hot wash cycle at 70°C (ideally with a biological enzyme–containing detergent) will disinfect laundry.

Cleaning sex toys

• First check the toy for ageing: for instance, cracks or fissures in rubber are difficult to clean properly. If in doubt, get rid of it and buy a new one.
• Wear rubber gloves.
• Use a scrubbing brush and cold water first to remove any dried on bits (hot water would fix organic material to solid surfaces).
• Then wash it in washing up liquid and very hot water.
• Then soak it in one of the disinfectants mentioned above at room temperature for more than an hour, perhaps overnight. Air dry after soaking.

A toy which would get ruined by soaking can be disinfected in a different way:

• Pre–heat the oven to 140°C, 275°F, gas mark 1. Then put a small item in for at least 30 minutes. Larger toys may take longer to reach this required temperature.
• It may be worth checking your oven's thermostat with an oven thermometer, since not all oven thermostats are accurate!

Toys which cut or abrade the skin should ideally never be shared.