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Positive Policy Change for HIV Positive Healthcare Workers

Posted on Aug 19, 2013 by Sergio Ulloa ()  | Tags: AIDS, Davies, healthcare workers, HIV virus, legislation, NHS, policy, test

Changes to the current NHS policy regarding medical workers will mean that as of April 2014, HIV positive doctors, nurses, dentists in the UK will be able to perform surgical procedures as they could before the 1990s when the restriction was imposed. Chief medical officer, Dame Sally Davies made the announcements last week and declared that the existing legislation was outdated and introduced a change of policy from April 2014.

In the 1990s, Britain was coming out of a HIV and Aids epidemic. The stigma surrounding both conditions had resulted in a lot of misconceptions about the disease, and fear about it spreading from one person to another via simple cuts or wounds. As a result of this public feeling and the lack of understanding about the HIV virus at the time, a ban was put in place in 1993 which prevented people with the virus from carrying out internal treatments or surgery on a patient.

The aim was to limit the risk of HIV spreading from undetected cuts on hands or fingers which might bleed when they were inside the patient's body. This ban meant that qualified surgeons who had tested positive for HIV had to stop their work and move to a different area of medicine, and dentists who had to stop working and find a new profession because the very nature of their work increased the risk of transferring HIV.

During the 1990's, this practice of trying to control HIV by restricting medical workers who had the virus was the norm because there was limited medical research into alternative ways of controlling the virus. However, over the last 20 years, there have been incredible scientific developments in the field so that people with HIV can receive anti-retroviral drug therapy to control whether they are infectious or not. This medical progress also prevents the virus from being transmitted from medical staff to patients.

Last week, Dame Sally Davies brought the British medical profession and the British public up to date with how research into the success of medical treatments which has influenced the change in policy to lift the restriction on doctors, nurses and dentists. It is estimated that 110 HIV-positive NHS healthcare workers will be able to resume procedures on patients. In order to return to their medical careers, they must first consent to be added to a register of healthcare workers with HIV managed by Public Health England, and must agree to be monitored by doctors every twelve weeks to make sure they are on the correct medication and to ensure that their viral load is undetectable.

For some medical professionals, the change could not come soon enough. Many news reports featured stories about healthcare workers like Allan Reid, a HIV positive dentist who was a victim of the existing HIV policies. Reid lost his job as a result of the 1993 restrictions despite knowing that at the time of his diagnosis in 2007, he was taking treatment which meant he was not infectious. There are many other cases like Reid's whereby the UK policy had simply not caught up with medical improvements.

Under the existing policy, any NHS workers who could expose patients to potential HIV risk are required to test for HIV at the beginning of their medical career. All NHS staff are also obliged to undergo other tests if they think they might have been exposed to HIV at any other stage in their career, but this testing is not enforced by law so it is quite possible that many other doctors, nurses and dentists might have kept their HIV diagnosis quiet to avoid the implications for their career if they admitted to having the virus.

While this new policy change represents a huge step forward, Doctor Davies also drew attention to the fact that there is still much work to be done in terms of changing attitudes towards the HIV virus. An important part of last week's announcement focused on creating a better understanding of what it means to live with the HIV virus in 2013. This will mean spreading the message that having HIV doesn't prevent people from living long, healthy lives. It is believed that wiping out old associations with the virus will encourage more people to get tested, and this includes healthcare workers may not have been tested because they don't want to lose their profession if they test positive.

The key here is diagnosing the virus in good time. To facilitate this, a second policy change will take effect concerning the sale of HIV self-testing kits in the UK. The widespread availability of tests should help to reduce the stigma that still surrounds HIV testing, and should make it easier for people to do an initial test at home and to provide initial advice about a follow up test at an NHS clinic to confirm the results.

Up until now, this has not been prioritised, so the public has had to resort to purchasing self-testing kits online. The lack of legalisation has meant that for too long, poor quality tests have been the only option for people living in the UK. As of next year, there will be a push to ensure that self- testing kits are more widely available and that those on sale are regulated, accurate and safe. It is hoped that this will go some way towards diagnosing the 25 per cent of the 100,000 people in the UK, who do not know that they are infected and will reduce the risk of the virus being transmitted to others.

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