Abstract
Recent papers report HIV sequence clusters in sub-Saharan Africa best explained by bloodborne transmission. Based on these clusters and on persistent reports of HIV infections best explained by bloodborne transmission, this brief considers three policy challenges for regional governments: (a) whether to warn the public about HIV risks during health care; (b) how to find and stop HIV transmission through medical procedures; and (c) whether to punish careless healthcare workers. Consideration of these challenges leads to three recommendations: Governments can warn the public about risk during health care are by inviting patients attending medical facilities suspected to have caused one or more recognized infections to come for tests. Governments that do so can find and stop bloodborne risks. Not punishing healthcare staff facilitates such investigations.