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Clearance for HIV-positive health care workers

Under a new system, healthcare workers living with HIV will be able to return to their chosen profession. (Photo: lenetstan/Shutterstock)

Thu. 20 February 2014

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LONDON – The Department of Health (DoH) has announced a system of health clearance for healthcare workers living with HIV whose disease is adequately controlled, so that they are able to return to their chosen profession.

In August 2013, Chief Medical Officer Sally Davies announced that health care workers who are HIV-positive will be able to return to practice, and now the DoH announced a system of health clearance, setting those wheels in motion. In January 2011 the DoH said that it was reviewing its policy on the prevention of HIV-positive surgeons and dentists from carrying out ‘exposure-prone procedures’, and now the day has come for the UK to fall in line with most other Western countries, and give these health care workers their careers back.

As Kevin Lewis, Dental Director of Dental Protection put it: “After decades of living in fear and dealing with prejudice, dentists can finally return to their professional calling, although regrettably it is too late for some to do so. Patient safety should be at the forefront of healthcare, but the original rules were introduced as a reaction to a mysterious and exceptional case, the likes of which we have not seen before or since.”

The regulations were brought in after the publicity associated with the death of a US dental patient in 1990, one of six patients believed to have been infected with HIV in an unresolved Florida case. Regulatory bodies in most countries responded to the case differently – the UK banned all HIV-infected health care professionals from undertaking exposure-prone procedures, leading to health workers becoming deskilled, losing their careers, or suffering in silence. Since most dental procedures are classified as exposure prone, the ban had a devastating significance for dentists diagnosed with the disease.

Decided on a case-by-case basis, HIV-infected health care workers may be allowed to undertake certain procedures if they are on effective combination antiretroviral drug therapy (cART); have an undetectable viral load; and are regularly monitored by their treating and occupational health physicians.

Those with HIV wishing to perform exposure-prone procedures will need to be registered on a confidential national register, the UKAP-OHR. An interim paper-based version is being made available to allow healthcare workers to register, whilst the webbased version is in development and will be made available in April 2014.

This article was published in the February issue (No. 2, 2014) of the Dental Tribune United Kingdom Edition.

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