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

Advice for Stranded Travellers

posted: 21/04/2010

Some people with HIV, stranded by the air travel chaos following the Icelandic volcano’s ash cloud, are running out of HIV medications. Here’s what to do.

It is very important to provide as much documentation as possible in order to limit the cost to you.

Stuck in the UK?
People with HIV stuck in the United Kingdom who are running out of HIV medication can approach HIV clinics in the UK for medication, but may be charged at the discretion of the clinic. Whether an individual is charged will depend on their country of residence.Find a clinic using NAM's database of services.

If you are from a country in the European Economic Area (European Union plus Liechtenstein, Switzerland, Norway and Iceland) you will not be charged, if you produce your European Health Insurance card. If you cannot produce your card, you will be charged and issued with a receipt, and you can claim the cost when you return home. If you do not have this card, you can obtain one from your country's embassy in the United Kingdom, usually within 24 hours.

If you are stuck in the UK but from a country outside the EEA that has a reciprocal health agreement with the United Kingdom, you will not be charged if you can show your passport. Countries with reciprocal agreements 

If your stuck in the UK and your country of residence does NOT have a reciprocal health agreement with the UK, you will be charged.

Examples of help and BHIVA's advice

In London a number of National Health Service HIV clinics are issuing medication. At the Chelsea and Westminster Hospital for example, individuals needing medication can obtain an appointment with an HIV doctor and will receive a prescription for two weeks’ worth of medication.

Policies may vary at other clinics, and British HIV Association chairman Dr Ian Williams is writing to all HIV doctors in the UK to ask them to be flexible if approached by patients who are not registered at their clinic.

In addition to the cost of drugs, some clinics may charge a fee for the consultation with a doctor.

Stuck outside the UK?
People with HIV from the UK who are stranded overseas can approach local HIV clinics or support organisations for help. You can search for organisations and clinics by country here.

What you pay will depend on the country where you are stuck. If you have the European Health Insurance card, you can use this throughout the European Economic Area to obtain whatever is freely available through the local health system. You will have to pay any local costs that would be normally met by local residents from their own pockets or health insurance, such as co-payments on medicines.

A similar situation applies for countries with reciprocal health agreements. You can check the list and find out what is freely available here  and find general advice for British citizens on health care abroad here.

Get an email/fax from your clinic

Your clinic in the UK should be able to provide a letter, by email or fax, to the foreign hospital detailing what treatment you are receiving and what drugs you need - in particular the correct dosages. Many HIV doctors may be away this week, attending the British HIV Association annual conference in Manchester. If you do not have contact details for other staff at your HIV clinic, you can find them here.

An NHS prescription is not valid overseas and you may need to obtain an appointment with a doctor in order to get a foreign prescription, but this will not be the case in all countries. In some countries it you can buy anti-retrovirals from a pharmacy without a prescription.

Source

USA HIV Travel Ban Goes

posted: 13/01/2010

On 4 January the USA travel ban on people living with HIV was finally ended. Notoriously the Dutchman Hans Paul Verhoff was refused entry into the U.S. in 1989 to speak at a HIV conference in San Francisco. Many people then boycotted the 6th International Conference on AIDS in San Francisco in 1990.

What began first as an administrative ban then became law in 1987 (through action by the homophobic republican Senator Jesse Helms) and this was reinforced in 1993.
 

The travel ban prevented visits to the USA by people with HIV apart from in exceptional circumstances. Officially people with HIV had to apply for a special permission. It was a difficult and slow process and many were refused. The stigmatising nature of the ban was reinforced because your passport was marked in a way which showed you have HIV.

The ban was widely ignored, but often people with HIV were detected by US immigration staff and then refused entry and deported. Others took risks with their health by interrupting their HIV treatment to enter without HIV being discovered.

Washington 2012 International AIDS Conference confirmed

Now the ban has been lifted the International AIDS Society has confirmed that the 2012 International AIDS Conference will be held in Washington DC. 3 in 100 living in the US capital have HIV, well above the threshold for a severe, generalised epidemic, which is 1%.

UK passport holders with HIV who wish to visit the US can now complete the green 'visa waiver' form that allows routine entry to the USA.

South Korea relaxes rules
The South Korean government has also announced that entry restrictions on people who don’t need a visa to enter were lifted from January 1st.

International HIV travel summary
A list of countries and their entry policies for people with HIV can be in NamLife here.

USA HIV Travel Ban Consultation

posted: 27/07/2009

The notorious ban on people living with HIV from entering the USA is under official review. There is a  public consultation by the US Centre for Disease Control and Prevention.

Have your say - opposition to removing the HIV ban is loud

So far many comments are opposed to the removal of the ban, so if removing this ban is important to you please consider posting your support message. 

Official information on the proposals and email them your comments - click the Submit Comments link on that page (this starts a blank email) or email your comments direct

You may like to say something like the statement by Paul Thorn, the Brighton-based HIV treatments access campaigner, who should have spoken at the Pacific health summit in Seattle in June, but was refused entry to the USA after stating his HIV status on his visa-waiver application. This statement was read out to that conference and was the immediate cause of the policy review that is now underway:

"The US government gives people who have HIV one of two choices. The first is to actually be dishonest on the visa application or visa-waiver form, commit a felony by lying to US immigration, and become a criminal. The second choice is to be honest, and have a visa rejected because you are considered an undesirable person, and unfit to enter the US. To my mind either being a criminal or an undesirable isn't much of a choice. I don't want to be either."

He points out that the question asking whether he was HIV positive on the visa-waiver form was alongside questions asking if he was a terrorist or Nazi.

You might add that the USA is rightly acting as a global leader in fighting HIV but this HIV travel ban is incompatible with world leadership on HIV. The ban contradicts the international UNAIDS policy.

Our report on the conference.

There is information on the current USA HIV entry rules here.