End to HIV Health Staff Ban?

posted: 10/02/2011

The much criticised ban on surgeons and dentists with HIV from working could be lifted this year. At long last, the government is acting on HIV campaigners’ calls to end the employment ban.

Department of Health rules stop HIV-positive health workers from carrying out what are called ‘exposure prone procedures’ which are thought to risk HIV and hepatitis transmission. Basically 'exposure-prone procedures' are treatments where the healthcare hand goes inside the patient body, especially when there are sharp things like bones and surgical tools around - like when a dentist is extracting teeth.

But the rules are old and there is very little solid evidence of actual HIV transmissions from health care workers to patients. Despite this, the UK rules mean no dentist with HIV can carry on working as a dentist, and many midwives, surgeons, some nurses and ambulance workers have also had to end or change their careers.

Rules review

The Department of Health has now said there will be a review of the rules. HIV charities have been invited to join the working group that will draw up new guidelines.
 

The British bans on healthcare workers with HIV and hepatitis are stricter than in many European countries and the USA and Australia, where dentists with HIV can work, so there are alternative rules ready to be adapted for Britain.

Evidence gap

With effective HIV treatments there is usually almost no virus in healthcare workers’ blood, so whatever risk there was, is even smaller now, say campaigners. It is extremely unusual for blood-borne viruses to be passed between doctors and patients. Only four patients worldwide are thought to have contracted HIV from health workers. There have been no transmissions from healthcare workers in the UK. And there are significant doubts about the evidence even for these few transmissions. 

Deborah Jack, chief executive of the National Aids Trust, said ‘advances in testing technologies and treatment’ and ‘high levels of infection control’ supported calls for change.

Catherine Murphy, of the Terrence Higgins Trust, added: ‘We’re not saying entirely lift restrictions but it is time for another look – especially for dentists.’ The British Dental Association has backed calls for change.

UK healthcare workers and exposure prone procedures policy

Source

End HIV Dentists Ban

posted: 26/10/2010

A call has gone out to end the Department of Health ban on people with HIV from treating dental patients. The ban continues despite the evidence that there is no risk of transmission.

A spokesperson for Dental Protection, who are indemnity providers, says: ‘It is 20 years since the draconian rules were introduced preventing dentists (and other healthcare professionals) from providing treatment to patients.

‘Initially introduced as a precautionary measure soon after the mysterious case of Dr Acer, a dentist in the USA who was thought to have infected six patients, there has never been any other recorded transmission of the disease in a dental setting.'

Out of date ban forces out of work

Meanwhile many UK dentists – along with dental hygienists and therapists – have lost their livelihood because they have been forced to stop working in their chosen profession.

Dental Protection continues: ‘On being given their own diagnosis they were told to “clear their desk” with immediate effect.'

Europe, Australia, USA – Dentists with HIV: no problem
HIV treatments now effectively control HIV, so that the levels of HIV in the blood are too low even to measure. This, with the high standard of infection control that is demanded of dentists, means that this outdated ban on dentistry for people with HIV has disappeared in much of Europe, Australia and the USA.

International declaration from Beijing
The Beijing Declaration from the 6th World Workshop on Oral Health and Disease in AIDS in April 2009 highlighted the outdated stance currently adopted by the Department of Health.

Department of Health discrimination?
The Department of Health in England’s failure to update its ban and guidance despite the consensus of evidence-based opinion means the Department risks complaints of discrimination.

Standing up for dentists with HIV
In calling for greater fairness and a more consistent application of the evidence, Kevin Lewis, director of Dental Protection, says: ‘Dental Protection has championed the cause of HIV-infected dental health professionals for more than a decade in several parts of the world and will continue to take action against this kind of unfair and discriminatory treatment of its members.

‘The international evidence base is overwhelming and the Beijing Declaration unequivocal in confirming that HIV infected dentists can continue to practise safely with no risk to patients, subject only to some very clear and manageable criteria being met.

‘In every other area of professional activity, dental health professionals are directed to follow the evidence base, but HIV has for too long remained a singular exception – during which time careers have been destroyed, lives have been devastated and patients have been deprived access to safe dentists.'

He continues: ‘The time has come to acknowledge the evidence and stop running scared of ill-informed public perception and media scaremongering. It seems to be forgotten that infected dental health professionals are also patients themselves and they should they be treated no less fairly than other patients. The sound of foot-dragging has been deafening and some immediate action needs to be taken to bring the UK guidance out of the previous century.'
 

Source

Dentists in Manchester

posted: 01/06/2010

NHS Manchester is making efforts to improve dental health and access to NHS dental care. Four new practices have opened in the last 18 months and 3 more will open by September.
 

Dental health is important for people living with HIV.

Urgent?
There are 32 appointments reserved across the city for people needing urgent dental care.
 

Call the Manchester Dental Helpline on 0161 230 6011
 

The Helpline will arrange emergency appointments, usually on the same day and close to home, and also signpost people to dentists with space for new patients and advise about dental services.
 

HIV and dental care

Regular visits to the dentist are important for people with HIV. Not only will this help general dental health, but it also allows dentists to check for gum and mouth disorders, such as oral thrush and badly bleeding gums, which are more common among people living with HIV.
George House Trust and the HIV clinic can help you find an NHS dentist, or a dentist that is particularly skilled or interested in treating people with HIV. Not all dentists offer NHS care.
 

Tell or not?
It’s a good idea to let dentists know of significant medical conditions like HIV, or if are taking any medication. This will help them ensure that you receive the most appropriate treatment. It is unprofessional, and also illegal for dentists to discriminate against you because of HIV, race, or sexuality or other reasons under equality laws.
 

Dentists have been told by the General Dental Council that they cannot refuse to treat somebody just because they are HIV-positive. And universal hygiene precautions are enough to prevent the transmission of HIV during dental treatment.
 

Namlife on dental care

HIV+ Working Surgeon

posted: 14/01/2009

An HIV-positive surgeon in Israel is being allowed to continue working. He or she is taking HIV treatment and has an undetectable viral load. The Israelis have effectively issued a statement, rather like the Swiss statement we have been reporting on over the last year. Both statements are about how effective HIV treatment can reduce infectivity to close to zero.

simple precautions are enough

The Israeli Ministry of Health has decided that the surgeon with HIV who is receiving antiretroviral treatment may return to carrying out invasive surgical procedures, providing that he or she maintains an undetectable viral load, follows infection control procedures and uses two layers of surgical gloves when operating. 
 

Time for UK HIV+ healthcare workers ban to be reviewed

Healthcare workers with HIV are routinely banned from surgical procedures of any kind, even very minor ones such as stitching wounds. This affects some doctors, midwives, some nurses, dentists, and some ambulance staff, among others. 
 

The Israeli decision is increasing the pressure on bodies regulating UK and other countries' healthcare employment to review their guidance on healthcare workers with HIV engaging in exposure-prone, invasive procedures.

In the United Kingdom, for example, the General Medical Council and the General Dental Council require that HIV-positive healthcare workers desist from carrying out exposure-prone procedures – anything that involves cutting, suturing, use of needles or delivery of babies using forceps or suction, and almost all dental work, – and all healthcare workers recruited to the National Health Service who will be carrying out these types of procedures are tested for HIV. Many healthcare workers have been forced to retire or change careers as a result of the guidance, including several in the NorthWest of England.
 

The Israeli statement is the first official acknowledgement that HIV treatment reduces the risk of bloodborne HIV transmission to such low levels that a doctor, dentist, nurse or midwife can continue working.
It could help reduce stigma for people with HIV, as long as media storms about fears of HIV transmission from healthcare workers can be avoided.
 

NAM's HIV Treatment Update in August/September took a detailed look at whether healthcare workers should be allowed to carry out surgical procedures.
 

HIV is present in potentially infectious quantities in blood, semen, vaginal fluids and breastmilk and, as a result, HIV can be passed on through injecting drug use, unprotected sex, and from a mother to her baby.
 

It’s not inevitable that a person exposed to HIV will become infected with the virus. One of the factors that affects this risk is the viral load of the person with HIV. HIV treatment lowers viral load both in blood and genital fluids.
There’s recently been a lot of debate about the infectiousness of people taking HIV treatment who have an undetectable viral load.
 

Swiss doctors kick-started the debate about a year ago. In a statement, they said that a person taking HIV treatment, who’d had an undetectable viral load for at least six months, who took all their medication and who didn’t have a sexually transmitted infection, was not infectious to their heterosexual partners.
 

The current consensus seems to be that HIV treatment, and all the Swiss conditions, reduces the risk of sexual transmission, but that a small risk may still be present.
 

Full report in the USA's Morbidity and Mortality Weekly Report
Some further details are in the aidsmap report
Source
 

Manchester, HIV and Dentists Survey

posted: 12/11/2008

NHS Manchester is aware that people living with HIV have different experiences of accessing and being treated by NHS dentists in Manchester. They want everyone in Manchester to be treated fairly and equally and so they are working with George House Trust and other voluntary sector organisations to collect from people living with HIV their experiences of using NHS dental services.

All information given will be treated confidentially and will be used anonymously to make recommendations to the NHS commissioners (who arrange and pay for the NHS dental service) and to the dentists (who provide the treatment).

The survey uses a secure and confidential survey system. If you have any queries please do not hesitate to contact Engagement Manager, Val Bayliss-Brideaux on 0161 217 4311.

Go to the survey

You can also write to FREEPOST RRSS-EKKJ-RRKY, Baguley Clinic, M23 1NA

 

Remember, if you are having difficulty finding a NHS dentist or have a question about local health services, you can contact the Patient Advice and Liaison Service on 0161 219 9451 or you can email them. This is a free and confidential information and advice service for NHS Manchester. PALS is open Monday to Friday from 9.00am - 5.00pm and if the line is busy, please leave a message on the 24-hour confidential answer-phone and you will be called back.