Four women were seated on a couch waiting for their turns to get their nails done inlcuding Halima Fredy, 31, at a Makumbusho-based nails salon to get manicure--a cosmetic treatment of the hands involving shaping and often painting of the nails, removal of the cuticles and softening of the skin.
While Halima was waiting for her turn, she picked her mobile phone and started browsing on internet to keep herself busy.
Surprisingly, she came to notice that the manicurist was using the same tools on more than one person without first disinfecting or sterilising them—a situation that can result in transmission of viruses or bacteria from one person to another, according to researchers.
“I was shocked! When my turn came to get my nails done, I refused the service, and I asked him to use new tools,” narrates Halima in an interview with Your Health.
Manicurists perform services that require them to actually “lay hands” on their clients. They use a variety of potentially hazardous substances in their practices — chemicals, sharp tools (cuticle pusher, nail buffer, cuticle nipper) and chemical procedures that alter hair, skin, or nails.
The improper disinfecting of these tools and equipment can spread infectious diseases and bacteria from one person to another, medical sources indicate.
“I am aware that a person can contract HIV infection through sharing of unsterilised manicure equipment and that is why I asked the manicurist to use new tools. I purchased a cuticle pusher for Sh1000 only,” says Halima.
Yohajo Nailbar, a manicurist with ten years of experience, acknowledges the presence of unprofessional manicurists in the city who use the same tools on more than one person without first disinfecting them.
“As a manicurist, I recognise that salon must have clean working equipment and a clean work area as I always must wash and disinfect all tools and instruments before I use on my customers,” says Yohajo in an interview with Your Health.
He adds, “I charge between Sh25,000 and Sh30,000 for manicuring, which includes a set of new tools, while other cheap salons charge between Sh5,000 and Sh10,000. So you can imagine! They don’t even have sterilisation devices,” says the manicurist.
The medical sources indicate that people can contract other diseases — including hepatitis B, hepatitis C and other pathogens — if manicure instruments are not sterilized between users.
The Centers for Disease Control and Prevention (CDC) lists numerous potential alternative sources of HIV transmission. Although manicure instruments is not on this list of alternative sources.
A case of HIV transmission that may be linked to sharing of manicure instruments is presented in AIDS Research and Human Retroviruses, which describes the case of a 22-year-old woman in Brazil who tested positive for HIV, likely contracted the virus through the use of manicure instruments that she had shared with an HIV-infected cousin.
The woman was diagnosed with HIV in 2013 when she donated blood.
The woman also said she had never had a blood transfusion, surgery, piercing or tattooing, which could have been potential vehicles for transmission.
About 10 years before her diagnosis, the woman had shared manicure instruments with her HIV-infected cousin. The cousin had been diagnosed with HIV 17 years before, but at the time when the women shared the equipment, the woman in the new case did not know that her cousin had the virus.
Do manicurists need to be licensed?
In a country like the US, law requires individuals to be licensed as a manicurist or cosmetologist to perform manicures or pedicures with the focus on protecting the health and safety of the public.
But such a legislation is not existing in Tanzania, however the Executive Director of Tanzania Commission for Aids (Tacaids), Dr Leonard Maboko thinks that in the future there would be a need to introduce a legislation with a focus to ensure that cosmetologists or manicurists are licensed to perform the services.
“This is something that is worth a discussion. So if we have to introduce the legislation that will require the manicurists to be licensed, it means that the law will also be applied to other individuals working at hair salons and others,” Dr Maboko says.
HIV transmission through sharing of unsterilized tools regarded as ‘rare’
HIV transmission through sharing of non-sterile sharp instruments such as those used for manicuring or pedicuring, barbering, circumcision, facial scarification, incision, tattooing, ear perforation, bloodletting, injections and acupuncture have always been vaguely classified as ‘rare’ and given less attention, medical sources indicate.
However, the sources emphasise that people should be aware that sharing any tools with possible blood to blood contact, such as needles used for drugs, tattoos, or acupuncture can result in transmission of viruses and bacteria.
“The possibility of HIV infection to spread from one person to another person through sharing of unsterilized sharp tools ranges from 0.5 per cent to 3 per cent. But we can’t ignore it. Doubling of efforts is necessary to raise public awareness,” says Dr Maboko.
“If a tool cannot be disinfected such as a nail buffer, it must be thrown away immediately after use. Don’t allow manicurist to perform a service if they don’t use a clean set of tools,” Dr Maboko adds.
A research scientist from Tanzania’s health research organisation-Ifakara Health Institute (IHI) Dr Fredrick Haraka calls for reinforcement of HIV/AIDS care and prevention strategies with a focus on educating members of the community on the importance to abstain from sharing of unsterilized sharp tools between users.
“Various viruses can be transmitted through the use of unsterilized sharp tools,” says Dr Haraka.
Knowing that there is no local study conducted in this specific area yet, the researcher further says there is no need to conduct such research, noting that it is well known that HIV infection can be transmitted from one person to another through sharing of dirty sharp instruments like razor blades and needles.
HIV/AIDS burden in Tanzania
Tanzania’s extensive rollout of antiretroviral treatment medications has helped minimise the impact of the country’s epidemic over the last decade.
In 2018, 1.6 million people were living with HIV in Tanzania. This equates to an estimated HIV prevalence of 4.6 per cent.
In the same year, 72,000 people were newly infected with HIV, and 24,000 people died from an AIDS-related illness.
The severity of the epidemic varies across the country. Some regions report an HIV prevalence of around 1.5 per cent (Manyara) while other regions have prevalence as high as 14.8 per cent (Njombe).
Overall, the epidemic has remained steady because of on-going new infections, population growth and increased access to treatment (UNAIDS Data 2019).
However, as in other countries in sub-Saharan Africa, unprotected sex remains the primary mode of HIV transmission in Tanzania. The spread of HIV in the country has been attributed to the low rate of condom use combined with the high rate of multiple sexual partners.
Don’t be afraid to speak up just like the way Halima did. Your health matters.