The extent of compliance of hospital employees with universal precautions was investigated. Altogether, 1,716 health care workers from three hospitals completed a questionnaire regarding compliance with universal precautions and demographic and personal, psychosocial, and organization management factors. Statistical analyses were used to determine the association between compliance and the sociodemographic, psychosocial, and organizational factors. The highest level of compliance was seen for the use of gloves and the appropriate disposal of sharps and contaminated wastes. The lowest compliance levels were seen for needle recapping, the use of protective eyewear and outer clothing, and cleaning up spills. The highest compliance rate (28%) among the facilities surveyed was observed in the mid Atlantic facility with the highest prevalence of blood borne infections. Overall compliance for the three sites for all of the 11 items assessed for universal precaution compliance was 23.7%. Univariate analysis indicated significantly higher compliance in workers with fewer than 16 years of education, fewer than 50 hours of work per week, a higher level of knowledge about alternative modes of transmission of the human immunodeficiency virus (HIV), a low conflict of interest between the need to protect themselves and the need to provide patient care, and less inclination toward risk taking. Psychosocial factors contributing to compliance included attitude toward HIV positive patients, perception of effectiveness of universal precautions, work related stress levels, and fear of occupational HIV transmission while related organizational factors included perception of the safety climate of the hospital and providing safety training.