Nurses With Hiv: Fear And Loathing On The Frontline
02 September, 2009By Charlotte Santry
A survey carried out by the National AIDS Trust has found that staff with HIV working in the health service face discrimination. Charlotte Santry looks at the findings and reports on the legal rights of nurses working with the virus, their colleagues and patients
Nurses living with HIV are being shunned by colleagues, told they should not be working in healthcare and suffering breaches of confidentiality.
These are the findings of a National AIDS Trust study, which showed a fifth of respondents who disclosed their HIV status at work felt they were discriminated against as a result.
Of 1,800 gay men and black Africans taking part, nearly one in 10 worked in healthcare and this included nurses working in a range of settings, from accident and emergency to mental health.
NAT assistant director of policy and campaigns Eleanor Briggs said: Stigma remains a real issue, theres still a lot of misunderstanding.
You might expect people in a healthcare setting to be the most informed. We found that wasnt the case and people faced a range of negative responses.
Nurses involved in the research said they were treated differently from other colleagues, made to feel isolated at work and were not invited to social events.
Terence Higgins Trust head of policy Lisa Power said: The NHS should be ensuring that anybody with HIV is supported to do their job. It should be setting an example but quite often its setting a bad example.
About The Infected Person :
- Is the source HIV negative or positive? They could be infected but not know yet. One in seven people living with HIV are unaware.
- Has the source had possible exposure to HIV through sex with multiple and/or anonymous partners, condomless sex, anal sex where both partners have a penis, or use of recreational drugs, injection drugs, or methamphetamines?
How Is Hiv Spread
- vaginal or anal sex without a condom, or other form of barrier protection, with a person who has detectable levels of HIV in their blood. People on treatment for HIV with undetectable levels of HIV cannot transmit the virus through vaginal or anal sex. Unprotected oral sex is extremely low risk for the transmission of HIV
- sharing needles, syringes and other injecting equipment with a person who has HIV
- transmission from mother to child during pregnancy or childbirth and through breastfeeding, if the mother has untreated HIV infection and detectable HIV in her blood or breast milk.
HIV cannot be spread via:
- casual contact such as shaking hands, kissing, hugging or massage
- being washed
Even if a healthcare worker has HIV infection, there are strict infection prevention and control guidelines that protect you as the patient.
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Panic Spreads As Over 500 Test Positive For Hiv In Pakistan’s Larkana
Current state-of-the-art combined antiretroviral therapy is not a cure for HIV. It can only suppress the virus – cause it to become latent. In some cases, cART is known to fail even when patients fully follow their drug regimen. Certain negative effects are also associated with cART, such as the build-up of toxic molecules leading to ‘oxidative stress’ and loss of function in the mitochondria, the cell’s powerhouse.
These effects can contribute to inflammation and organ damage. Stopping cART is also not an option because the virus can reactivate – emerge from its latent state – in the absence of therapy.
Scientists have recently begun exploring the beneficial effects of the presence of H2S in HIV-infected cells on both oxidative stress and mitochondrial dysfunction, according to Amit Singh, Associate Professor in MCB/CIDR and corresponding author of this study.
In a previous study, Singh’s lab developed a tool to measure oxidative stress in cells infected with HIV.
“In that work, we showed that the chemical agent N-acetylcysteine was able to suppress HIV reactivation from latently infected cells,” he explains.
Previous work from Singh’s lab has also looked at the effects of counteracting oxidative stress by an antioxidant nanozyme during HIV infection.
“Since H2S also functions as an antioxidant molecule, we wished to see whether our prior insights on oxidative stress and HIV could be translated to show the contribution of H2S on HIV infection.”
Is Hiv And Aids An Occupational Concern
Where ever there is the possibility of contact with blood in the workplace, workers should take precautions to prevent contact with the skin, eyes or mucous membranes .
Routine Practices are recommended to prevent the spread of HIV in the workplace. Routine practices are based on the principle that all blood, body fluids, secretions, and excretions except sweat, non-intact skin, and mucous membranes, unless they contain visible blood, may contain transmissible infectious agents. Steps involve using protective clothing such as gloves, gowns or aprons, masks and protective eye wear when dealing with people’s blood and other blood-contaminated body fluids such as semen and vaginal secretions. They also do not apply to saliva except in dentistry where saliva is likely to be contaminated with blood.
Hand washing after contact with blood, blood-contaminated body fluids and soiled items is also recommended to reduce the risk of infection.
The best approach to most diseases is to prevent their occurrence – occupationally-related diseases are no exception. In the case of HIV, prevention is the only cure.
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Doctors Dentists And Health Workers With Hiv Could Work In Nhs
Doctors, dentists and health workers with HIV could soon be allowed to practise again, under new Government plans.
The Department of Health has launched a consultation into the issue with a view to lifting the ban that has been in place for 20 years.
As reported in the Daily Telegraph last week, ministers fear a backlash from patients, but hope that those concerns can be allayed when presented with the facts about possible dangers.
Some countries already permit HIV positive doctors and dentist to work, but despite evidence that any risk is negligible the UK still has tough restrictions in place.
The issue is certain to cause controversy. Three years ago a London doctor, Allan Reid, sparked a health scare after treating thousands of patients without telling them he was HIV-positive.
A current court case, in which a dentist with HIV is bringing an action against the Department of Health claiming the current ban is discriminatory and unlawful, also explains why ministers are considering the change. Because of the case, the possibility of a judicial review is hanging over the Government.
Ministers will say that there have been no reported transmissions in Britain, despite more than 25 cases in the last 12 years where a patient has been exposed to an HIV-infected doctor, dentist or other health worker. More than 10,000 patients have been tested.
For less invasive procedures such as normal dentistry the risk is described as negligible.
Does Your Employer Need To Know Your Hiv Status
In most instances, HIV will make no difference to your employability or affect your ability to do your job. Therefore, there are very few jobs where there is an obligation to tell your employer that you have HIV. According to the Equality Act, it is illegal to discriminate based on HIV status. The provisions of this act apply in England, Wales and Scotland, with similar protections in Northern Ireland under the Disability Discrimination Act.
Applying for a job: Under the Equality Act, potential employers and recruitment agencies are not allowed to ask questions about health during the application phase. This is prohibited in any form such as questionnaires, verbal questions during an interview or asking previous employers health-related questions. The main exception to this is if your health condition will somehow affect your ability to carry out essential functions of the job. This is rarely the case with HIV.
“Being HIV-positive does not stop you from working in professions where there is close human contact, such caring, teaching or hairdressing.”
If an employer is asking unlawful health questions prior to offering employment, you can report them to the Equality and Human Rights Commission who regulate compliance with the Equality Act. Further information on how to do this is provided at the bottom of this page.
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The Patient’s Right To Know The Hiv Status Of The Health Care Provider
The MNA recognizes its duty to provide nursing care to all citizens of the Commonwealth, including those individuals with AIDS/HIV infection while protecting the rights of individuals, including health care workers, and the welfare of the public.
This duty is based on the first, third, fourth and ninth platforms of the ANA Code of Nurses and the recognition that nurses most binding duty is to do no harm to those under their care.
Nurses are entitled to the same protection against discrimination under state and federal laws as all other members of society. As health care professionals, they should take all precautions against exposure to, as well as transmission of, the HIV virus by utilizing the recommendations of the DCD, OSHA and DPH.
This position paper is organized as a series of questions that address various aspects of this issue. It is based on papers written by the Association for Practitioners in Infection Control and the Society of Hospital Epidemiologists of America, Massachusetts Board of Registration in Nursing, and testimony by the American Nurses Association on Risks of Transmission of Bloodborne Pathogens to Patients During Invasive Procedure before the Center for Disease Control. The Task Force provides positions and rationale based on the above papers as well as the expert knowledge of members on the Task Force.
New Nhs Guidelines On Doctors And Nurses With Hiv Will Change Lives
It is estimated by Saving Lives, an HIV awareness charity, that 110 people are HIV-positive and working in the NHS. It can only be estimated of course, because some we don’t know how many don’t know themselves or prefer not to tell anyone about it.
Perhaps that seems selfish? Perhaps you feel that patients have a right to know when the person treating them is carrying a life-threatening virus? Perhaps that person shouldn’t be treating anyone at all?
If this is your view, you need better information. Today, the truth is that it is virtually impossible to catch HIV from someone who is HIV-positive and receiving treatment. “People living with HIV who are on stable effective treatment will have undetectable levels of virus in their blood,” says Dr Steve Taylor, an HIV specialist at Birmingham Heartlands hospital and medical director of Saving Lives. “That means the risk of their blood infecting another person through a needle-stick injury is almost nothing. There have only been four cases worldwide of people being infected by a healthcare worker and those cases were in the early days before treatment was available. The risk of transmission of HIV to healthcare professionals is infinitely higher.”
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What Are Some Common Myths About People Living With Hiv
There is still a great deal of stigma directed towards those living with HIV. While many people are met with understanding and support, there is a chance that sharing information about your health could go badly.
This is often linked to outdated or limited knowledge about HIV. Some common myths about HIV could cause your employer to react badly:
- All those living with HIV will eventually progress to AIDS and will therefore become a burden
- You will need to take an excessive amount of time off work to manage your HIV
- HIV can be spread through sharing items such as utensils
- HIV can be spread through cuts, bites and so forth
- There are many jobs people with HIV cannot do because they pose a risk to others
- Most people living with HIV are promiscuous or irresponsible
In fact, the vast majority of people living in the UK with HIV are on successful antiretroviral treatment and their health is well-monitored. This leads to a suppression of the virus in their blood until it reaches undetectable levels. People with HIV who have an undetectable viral load are expected to live long, healthy lives. In addition, they cannot infect others through sexual contact.
HIV is not spread through sharing of personal items or through means such as saliva exchange or biting.
Currently in the UK, very few people living with HIV go on to develop AIDS or any AIDS-related complications.
Edmiston: As Hiv Funding Goes Down Hiv Infections In Canada Increase We Can Stop This
This World AIDS Day , youd be forgiven for thinking HIV is no longer a public health threat in Canada. We have new prevention options such as PrEP, a pill that HIV-negative people can take on a regular basis to stop infection. Weve seen the good news about HIV treatments, now so effective that they can restore a normal life expectancy to a person living with HIV and completely eliminate the possibility of passing it on to a sexual partner.
But statistics tell a different story. Between 2013 and 2018, the Public Health Agency of Canada estimates that HIV infections in Canada have been climbing a 31-per-cent increase over five years.
Why have HIV infections been increasing when we have more and better prevention options at our disposal than ever before?
Ask our federal decision-makers, who have not increased funding for the HIV response since 2008, and even fell short on spending the funds that had been allocated to the federal HIV initiative. At the same time, the federal government has broadened the scope of this fund once dedicated to HIV to also address hepatitis C and other sexually transmitted and blood-borne infections, an approach that could make sense if funded appropriately. But in practice, we have seen more organizations and more health issues competing for a slice of the same pie, resulting in funding reductions and service cuts for community-based HIV programs.
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How Does Hiv Affect The Body
The human immune system involves many types of cells which guard against germs responsible for most diseases. The immune system’s most important guard cells are B-cells and T-cells, which are special white blood cells. B-cells and T-cells cooperate to fight any germ that attacks the human body.
B-cells produce particular proteins, called antibodies, that try to neutralize the invading germ. After a person recovers from an infection, these antibodies continue to circulate in the bloodstream, acting as part of the immune system’s “memory.” Immune system memory explains why a person rarely suffers a second attack from an infectious disease such as measles. If the same germ is encountered again, the antibodies will recognize and neutralize it. T-cells attack the germ directly and try to kill it.
What Health Professionals Need To Know About Hiv And Aids
The human immunodeficiency virus is a blood-borne infection that can be transmitted:
- to an unborn child during pregnancy or delivery
- through sharing substance use equipment
Acquired immune deficiency syndrome is a long-term sequela of infection.
Consider and discuss HIV testing as part of routine medical care. Early diagnosis and initiation of antiretroviral therapy can lead to reduced morbidity and mortality associated with:
- HIV infection
- disease progression to AIDS
Timely awareness of serostatus can reduce HIV transmission due to reduction in risk behaviour. In addition, ART reduces transmission. People who adhere to treatment and who achieve and maintain an undetectable viral load have effectively no risk of transmitting the infection sexually.
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What Is Occupational Exposure To Hiv
- Your skin is broken by equipment that has been in contact with a patient’s blood.
- A patient’s blood gets into a mucous membrane, such as your eye.
- A patient’s blood gets into an open cut in your skin.
The most likely cause of HIV exposure is from a contaminated needle, known as a needlestick injury.1
Assessing The Connection Between Hiv And Depression
As discussed, depression can stem from the psychological effects of an HIV diagnosis. Feelings of loss, worthlessness, and fear can lead to long-term mood disorders if support is not available.
However, physiological impacts of the disease can also cause depressive symptoms. For example, efavirenz, an active ingredient in several HIV medications, has been known to cause a variety of psychological symptoms, including depression.7 In HIV-positive individuals with severely compromised immune systems, opportunistic infections such as toxoplasmosis and cryptosporidiosiscan mimic or induce depression symptoms.8
Bloom notes that HIV puts the body in a state of constant inflammation, which takes a toll. The human body is an integrated system, so when the immune system is under attack, it affects how our brains function.
This creates a deadly cycle when depression caused by HIV infection interferes with a patients medication adherence. Depression can affect a persons executive functioning capacity, making it difficult to remember to take a daily medication regimen.9 Not taking medication can also serve as a form of functional denial about their illness: Bloom explains, Clients think, If I dont take medication, it isnt happening to me.’
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Can I Work In Healthcare If Im Hiv Positive
Healthcare workers with HIV can now carry out exposure prone procedures .
These are generally procedures where theres a risk that the healthcare workers blood could get into the body of a patient, such as during surgery, obstetrics, gynaecology, dentistry or midwifery.
Anyone applying for a role involving EPPs must have an HIV test. According to Public Health Englands guidance, if youre HIV positive you have to meet the following criteria to carry out EPPs:
- you must either be on antiretroviral treatment and have a viral load below 200 copies/ml, or be an elite controller and have viral load testing every three months, and
- be under the joint supervision of a consultant occupational physician and your treating physician, and
- be registered with the UKAP Occupational health Monitoring Register .
Elite controllers are people living with HIV who are not on treatment but have maintained their viral load below the limits of detection for at least 12 months, based on at least three separate measurements.