Recent HIV Rule Change for NHS Workers Highlights Fear and Misunderstanding

A couple of weeks ago, the UK government decided to repeal an outdated ban on health practitioners that prevents those who suffer from HIV from performing dental and surgical procedures. In April 2014, those who are infected by the virus will now be permitted to perform the same procedures as their colleagues. Alongside this, home testing kits, which have been banned since the early 1990’s, will now be legal and regulated by the Medicines and Healthcare Regulatory Authority.

Scanning electron micrograph of HIV-1 budding (in green) from cultured lymphocyte. Image from Wikimedia Commons.

At the moment, there are 110 people employed by the NHS who are affected by this current rule, working in areas such as obstetrics and gynaecology. Under these new rules, health workers will be allowed to carry out procedures if they are taking effective anti-retroviral drugs and have an undetectable viral load in their blood system. Alongside this, they will also undergo routine check ups every three months in order to monitor their situation.

And yet…when reading up on this subject after seeing a slightly scaremongering piece in a UK national newspaper (can you guess which one?), I saw many comments by those who were angry and afraid about this change in legislation, with a lot of them highlighting the lack of knowledge and mythology about HIV that is in the public mind.

So before I get into what I have seen, let’s get some facts about HIV.

HIV Facts

  • HIV stands for human immunodeficiency virus and is a retrovirus.
  • An infection by HIV leads to acquired immunodeficiency syndrome (AIDS) – this is the final stage of an HIV infection whereby the immune system is too badly damaged to operate properly, meaning that patients are more prone to opportunistic infections.
  • HIV is transmitted via bodily fluids such as blood, breast milk, semen, vaginal fluid and inside the anus.
  • Therefore, HIV is transmitted through unprotected sex (vaginal and anal), mother to baby (before/during birth and breastfeeding), contaminated surgical tools such as hypodermic needles and infected blood transfusions. Occupational risk is also high, meaning those who work in healthcare are at risk of acquiring the virus (not necessarily transmitting).
  • HIV CANNOT be transmitted by saliva unless it contains blood or other at risk body fluids. Nor is it an airborne virus, unlike the common cold. These two theories are MYTHS that first came about when HIV was new and public panic was widespread. (Excuse the bold capitals, but the point sometimes has to be enforced.)
  • There are about 100,000 people in the UK who are infected with the virus. With a current population of 63.7 million, that means that 0.15% (roughly 1 in 650) of the population are infected. Almost one quarter of these people do not know that they are infected.
  • HIV works by attacking our T cells (cells that are involved with our immune system) and replicating inside them, before destroying them and releasing the newly made viruses.
  • A late diagnosis is common as symptoms do not immeadiately become apparent, with many suffering flu like symptoms up to a month after infection, with a general feeling of ill health. Sometimes, someone will not present with any symptoms at all.
  • It’s unknown as to how HIV arose. The most common theory is that HIV is a mutated form of simian immunodeficiency virus (SIV), an infection that regularly infects chimpanzees. It’s thought that the virus ‘jumped’ between species (in a similar fashion to influenza), first infecting those who regularly hunted and ate bush meat. It is also thought that this infection was kept within small groups in Africa, but world travel went on to spread it worldwide.
  • HIV/AIDS was first thought to only infected gay men due to its high prevalence within this particular group, but it can affect anyone regardless of age, sex, race or sexual orientation.
  • HIV is hard to treat due to the antigen variability, meaning that the virus constantly changes itself, making drug treatments less effective.
  • A few people have been ‘cured’ (doctors prefer to call it remission) of HIV. This has been achieved through a full bone marrow transplant, with the first reported case being a man in Germany in 2008. This treatment is unlikely for many however, as bone marrow transplants are difficult and expensive.
  • Final Fact: the hepatitis B virus, which NHS workers are also screened for, is 50-100 times more infectious than HIV. 1 in 350 people in the UK have hepatitis B, compared to the previously mentioned 1 in 650 with HIV. 

What Do The Public Think of This Law?

When perusing newspaper sites, this article “More than 3,000 patients may have been exposed to HIV after Scottish dentist contracted infection” appeared in the Daily Mail. While the article did go on to state that nearly all the patients had been contacted and tested (with nobody being infected), the comments were still mixed, the most popular being those who were stating disbelief that the government is changing the law when ‘incidents’ like this occur. Following this came those who shared my belief that this piece was simply scaremongering.

After this, I had a look for more news articles about the change in law, finding pieces by the Independent, the Telegraph, the Guardian and Nursing in Practice (the links to each article has been hyperlinked into the titles, I’d recommend reading the article and then looking at the comments). From here, I saw the same mixed response in the comments, with one saying that they wouldn’t even recommend kissing a person with HIV, despite also saying that they know that it isn’t possible to transmit the disease that way. Thankfully, there were those who were responding to these comments, trying to explain what these new measures mean and how small the risk would actually be.

What do you think of this decision by the government? Would you like to be treated by a medical professional who has HIV, yet takes anti-retroviral drugs that reduces the risk to zero?

If you are concerned about HIV and would like some more information, here are some websites:

AIDS Awareness
AIDS Awareness (Photo credit: sassy mom)

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