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CHW56-HIV Awareness and Support Policy

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Registration Number: {{org_field_registration_no}}

HIV Awareness and Support Policy

1. Purpose 

The purpose of this policy is to ensure that {{org_field_name}} provides safe, person-centred, rights-based, confidential and non-discriminatory care and support to individuals living with HIV. The service will promote dignity, inclusion, equality, infection prevention and control, emotional wellbeing, access to appropriate healthcare, and protection from stigma, harassment or discriminatory treatment.

This policy supports compliance with the Regulation and Inspection of Social Care (Wales) Act 2016, the Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017, as amended, the Welsh Government statutory guidance for care home services, the Social Services and Well-being (Wales) Act 2014, the Equality Act 2010, the UK GDPR and Data Protection Act 2018, Public Health Wales infection prevention and control guidance, and relevant CIW requirements.

The service recognises that HIV is a manageable long-term health condition and that people living with HIV must be supported to live safely, confidently and without stigma. HIV status must never be used as a reason to refuse admission, restrict normal activities, isolate an individual, alter care inappropriately, or treat the individual less favourably.

2. Scope 

This policy applies to all staff, agency workers, volunteers, students, contractors and visiting professionals working in or on behalf of {{org_field_name}}. It applies to all areas of care and support where HIV-related information, support, medication, confidentiality, infection prevention and control, equality, safeguarding or wellbeing may be relevant.

This policy covers:

3. Understanding HIV 

HIV, Human Immunodeficiency Virus, is a virus that affects the immune system. With effective antiretroviral treatment, people living with HIV can live long and healthy lives. Where a person is taking effective treatment and has an undetectable viral load, HIV is not passed on through sex. This is commonly known as Undetectable = Untransmittable, or U=U.

HIV may be transmitted through specific routes only, including blood-to-blood exposure, sexual exposure, sharing injecting equipment, and from mother to baby during pregnancy, birth or breastfeeding where effective prevention and treatment are not in place. HIV is not transmitted through ordinary day-to-day contact in a care home.

HIV is not transmitted by:

Staff must use the same infection prevention and control standards for all individuals. Care must not be changed solely because a person is living with HIV, unless a specific assessed health need, medication need, risk assessment or professional instruction requires it.

4. HIV Awareness, Staff Training and Competence 

All staff will receive HIV awareness information appropriate to their role during induction and through refresher training at least annually, or sooner where there are changes in legislation, Public Health Wales guidance, CIW expectations, professional guidance, local procedures or the needs of individuals using the service.

Training and staff guidance will include:

The Registered Manager will ensure that training records are maintained, staff understanding is checked through supervision and observation of practice, and any learning needs are addressed promptly. Agency staff, volunteers and visiting workers will be given information relevant to their role before providing care or support.

5. Confidentiality, Privacy and Data Protection

HIV status is confidential health information and must be treated as special category personal data under the UK GDPR and Data Protection Act 2018. Information about a person’s HIV status must only be processed where there is a lawful basis, a valid special category condition, a clear care-related purpose, and a need for relevant staff to know in order to provide safe and appropriate care.

Staff must not disclose, discuss or confirm an individual’s HIV status to other individuals, visitors, relatives, friends, staff who do not need to know, external professionals who are not involved in the person’s care, or any other third party unless:

Discussions about HIV, medication, appointments, test results or personal circumstances must take place privately and respectfully. Written and electronic records must be accurate, proportionate, securely stored, access-controlled and shared only in line with the organisation’s data protection, confidentiality and records management procedures.

A person’s HIV status must not be displayed, marked or coded in a way that can be seen by unauthorised people, including on doors, noticeboards, medication trolleys, handover sheets or communal records. Staff must take particular care when sending emails, letters, care records, appointment information or medication information to avoid accidental disclosure.

Any actual or suspected breach of confidentiality involving HIV-related information must be reported immediately to the Registered Manager and managed in line with the Data Protection Policy, Information Governance procedures, duty of candour, safeguarding procedures where relevant, and disciplinary procedures. Breaches may be treated as serious misconduct.

6. Infection Prevention and Control

The risk of HIV transmission in a care home setting is extremely low when Standard Infection Control Precautions are followed. Staff must apply Standard Infection Control Precautions consistently for all individuals, regardless of known or unknown infection status, because infection risk cannot be reliably identified by diagnosis alone.

Staff must follow {{org_field_name}}’s Infection Prevention and Control Policy and current Public Health Wales/NIPCM care home guidance, including:

Staff must not apply additional restrictions, isolation, separate crockery, separate laundry, separate toilet facilities or different cleaning arrangements solely because a person is living with HIV. Any additional precautions must be based on an assessed infection prevention and control risk, current guidance, clinical advice or another specific infection risk, and must be proportionate, respectful and documented.

7. Medical, Emotional and Person-Centred Support for Individuals

Individuals living with HIV will be supported in a person-centred way, based on their wishes, needs, outcomes, consent and personal plan. The individual must be involved in decisions about their care and support, and their privacy, dignity, independence, relationships and rights must be respected.

Where relevant to the individual’s needs and consent, the service will support access to:

The personal plan must record any HIV-related support the individual wants or needs, including medication support, appointment support, confidentiality preferences, communication needs, emotional wellbeing needs, cultural or spiritual needs, and any reasonable adjustments. The plan must be reviewed at least every three months or sooner if the individual’s needs, wishes, medication, risks or circumstances change.

Staff must not make assumptions about the individual’s health, lifestyle, relationships, capacity, sexual orientation, past history or risk to others. Support must be based on respectful assessment, consent, professional advice where needed, and the individual’s own outcomes.

8. Equality, Anti-Discrimination and Inclusion

Under the Equality Act 2010, disability is a protected characteristic, and HIV infection is deemed to be a disability from the point of diagnosis. Individuals living with HIV are therefore protected from disability discrimination, harassment and victimisation. The service will also have regard to all other protected characteristics and will provide care in a way that respects the individual’s identity, dignity, rights, relationships, culture, language, religion or belief, sexual orientation and personal choices.

{{org_field_name}} will not refuse admission, withdraw care, restrict activities, isolate an individual, impose unnecessary conditions, disclose information, or treat a person less favourably because they are living with HIV or are believed to be living with HIV.

Reasonable adjustments will be made where needed to ensure that individuals living with HIV can access care, activities, healthcare appointments, relationships, visitors, complaints processes, advocacy, communication support and community life on an equal basis.

Discriminatory, hostile, humiliating, stigmatising or intrusive comments or behaviour by staff, volunteers, visiting professionals, contractors, visitors or other individuals using the service will not be tolerated. Concerns will be addressed through the relevant procedure, which may include dignity and respect, safeguarding, complaints, behaviour support, staff supervision, disciplinary action, referral to professional bodies, or reporting to external agencies where required.

9. Exposure Incidents and Post-Exposure Prophylaxis (PEP)

An exposure incident may include a needlestick or sharps injury, a bite that breaks the skin, blood or body fluid contact with broken skin, or a splash of blood or body fluid to the eyes, mouth or mucous membranes.

If an exposure incident occurs, staff must take immediate first aid action:

  1. For a needlestick, sharps injury or broken-skin exposure, encourage the wound to bleed gently. Do not suck the wound. Wash the area thoroughly with soap and running water and cover with a waterproof dressing.
  2. For a splash to the eyes, mouth or mucous membranes, rinse immediately and thoroughly with water or saline.
  3. Report the incident immediately to the nurse in charge, senior staff member, Registered Manager or Infection Prevention and Control Lead.
  4. Seek urgent medical advice immediately from occupational health, the local emergency department, NHS 111 Wales, or other local pathway. PEP is time critical and, where indicated, should be started as soon as possible and no later than 72 hours after exposure.
  5. Complete an accident/incident report and document the action taken, advice received and follow-up required.
  6. Follow local procedures for blood-borne virus risk assessment, staff support, testing, follow-up, RIDDOR reporting where applicable, and review of the incident to prevent recurrence.

The HIV status of any individual involved must remain confidential. Staff must not pressure an individual to disclose HIV status or undergo testing. Any discussion, consent, testing or disclosure must be handled by appropriate healthcare professionals in line with law, confidentiality, consent and clinical guidance.

The Registered Manager must ensure that exposure incidents are reviewed, learning is shared appropriately, and any required changes are made to equipment, training, PPE, sharps practice, waste management, staffing or procedures.

10. Safeguarding, Stigma and Duty of Candour

HIV-related stigma, discrimination, harassment, bullying, deliberate disclosure of HIV status, refusal of care, neglect, improper treatment or unnecessary restriction may constitute a safeguarding concern, complaint, disciplinary matter or breach of professional standards.

Staff must report concerns immediately where an individual living with HIV is:

The Registered Manager will ensure that concerns are managed in line with the Safeguarding Policy, Wales Safeguarding Procedures, Complaints Policy, Whistleblowing Policy, Data Protection Policy and disciplinary procedures as appropriate.

Where something has gone wrong in the provision of care and support, the service will act openly and transparently with the individual and, where appropriate, their representative, in line with the duty of candour. This includes explaining what happened, taking action to reduce risk, offering an apology where appropriate, and recording the actions taken.

11. HIV Medication and Treatment Support

Where an individual is prescribed antiretroviral therapy or other HIV-related medication, staff will support the person in line with the Medication Policy, the individual’s consent, the prescriber’s instructions and the individual’s personal plan.

The personal plan and medication records must clearly identify the support required, which may include prompting, administration, ordering, storage, monitoring, appointment support or liaison with the GP, pharmacist, community nurse or HIV specialist team.

Staff must not interrupt, delay, omit or alter HIV medication unless instructed by an appropriate prescriber or pharmacist. Any missed dose, refusal, side effect, medication error, supply issue or concern about adherence must be recorded and escalated promptly in line with the Medication Policy.

Staff who support individuals with medication must be trained and assessed as competent before doing so. Medication systems will be audited regularly, and any HIV-related medication support will be handled discreetly to protect the individual’s confidentiality.

12. Compliance, Monitoring and Quality Assurance

The Registered Manager, Responsible Individual and Infection Prevention and Control Lead will ensure that this policy is implemented, monitored and reviewed as part of the service’s governance and quality assurance arrangements.

Monitoring will include, where relevant:

Any shortfalls identified will be addressed through an action plan, supervision, retraining, policy update, referral to external advice, or other appropriate corrective action.

13. Related Policies 

This policy should be read alongside:

14. Policy Review 

This policy will be reviewed at least annually, or sooner if required due to changes in legislation, Welsh Government statutory guidance, CIW expectations, Public Health Wales/NIPCM guidance, Social Care Wales guidance, professional guidance, infection prevention and control practice, HIV treatment guidance, safeguarding learning, incidents, complaints, audit findings or the needs of individuals using the service.

The Registered Manager and Responsible Individual are responsible for ensuring that the policy remains current, accessible to staff, and implemented in practice. Staff will be informed of any changes and, where required, will receive updated training or guidance.

Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}
Reviewed on: {{last_update_date}}
Next Review Date: {{next_review_date}}
Copyright © {{current_year}} – {{org_field_name}}. All rights reserved.

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