Current rules regarding HIV are to be relaxed the DH has announced. These changes fall into two categories.
The first change is that the ban on healthcare workers with HIV performing certain procedures will be lifted. In terms of primary care, midwives will now be able to carry out certain procedures that before they may not have been able to do.
Jason Warriner, the clinical director of the Terrence Higgins Trust, said: ‘The changes in rules for workers is a good step forward as they can use their knowledge and skills to improve patient care. It will also help to normalise HIV and reduce the stigma. As for midwives, previously those with HIV were unable to be involved in labour, but now they may be able to. It is a common-sense approach, as it would seem unfair to stop a skilled midwife from performing certain procedures just because they have HIV.'
Workers will be allowed to carry out certain procedures if they are:
• on effective combination antiretroviral therapy
• have an undetectable viral overload
• are regularly monitored by their treating and occupational health physicians.
Dr Peter Carter, chief executive of the RCN, welcomed the step that nursing staff will no longer be banned from carrying out certain medical procedures. He said: ‘No one in this day and age should feel stigmatised to be living with HIV, as a long-term, manageable condition and we hope these changes will reduce outdated information about HIV risk, reduce stigma and improve HIV awareness among staff and patients.'
There have been just four cases worldwide of clinicians infecting patients and the last reported case was nearly a decade ago.
The second change is that people will now be able to buy HIV self-testing kits once they comply with regulations as it is currently illegal to buy kits that provide on-the-spot results in the UK.
Around 100,000 people have HIV in the UK but an estimated quarter of those are living with it undiagnosed. The DH says that the changes in restrictions to self- testing will give people more choice on how to get tested and receive treatment earlier.
If a test indicates a positive result people will be advised to get a follow-up confirmatory test at an NHS clinic. Clear information on how to interpret the result and what action to take afterwards will be included in the kit.
Ian Peate, editor in chief of British Journal of Nursing and visiting professor of nursing, said: ‘I'm not sure that there will be any need to retrain primary care nurses for the changes to the self-testing, but they do need to be aware of changes in self-testing. Testing kits are not always fallible, there is always a margin for error. Because of this nurses need to ensure that they are up to date with developments, types of tests and limitations in order to give their patients the best advice. ‘
Current rules prevent companies from selling HIV self-testing kits in England. Once the rules are lifted, all kits will be subject to strict regulatory control by the Medicines and Healthcare regulatory Authority before they are authorised for sale.
Deborah Jack, chief executive of the National Aids Trust (NAT), said: ‘We know people are already buying poor quality self-testing kits online which is why NAT have campaigned for a change in the law. Legalistation is an important step to ensure they are regulated, accurate and safe.'
Both policies will be in place from April 2014. PHE will now put in place a programme to register and monitor healthcare workers who have HIV and ensure that they are able to perform certain procedures when appropriate.