AIDS/HIV Policy

Policy Statement

This care service is committed to equality of opportunity and to eliminating discrimination in both its employment processes and service delivery. It is also committed to protecting and promoting the health of its employees and of people receiving care and their relatives and visitors.

{{org_field_name}} recognises that Acquired Immune Deficiency Syndrome (AIDS), caused by the Human Immunodeficiency Virus (HIV), is a health issue that has attracted widespread publicity, much of which is often misinformed. It is therefore necessary for people to be informed of the facts and where to turn for advice. To this end this policy has been developed for the benefit of both staff and people who use the services.

{{org_field_name}} will ensure that its policy challenges erroneous assumptions about AIDS/HIV infection and ensures that both its employees and people who suffer from AIDS/HIV infection are not discriminated against and are treated with dignity and fairness. Therefore, this care service will regard AIDS in the same way as any other serious illness.

This policy has been informed by HIV: A Guide for Care Providers, published by the National AIDS Trust in July 2015.

Background to AIDS/HIV

AIDS is caused by a virus known as HIV which attacks the body’s natural defence system and leaves it vulnerable to infections and cancers. There is currently no “cure” for HIV, but the drug treatments available now have much improved the prognosis, particularly for those who are diagnosed early. When diagnosed and treated effectively, most people with HIV will not develop AIDS and are likely to have a near-normal lifespan; however, those who do develop AIDS will die from the illnesses it causes.

HIV infection is mainly transmitted by unprotected sexual intercourse with another person who has the virus. Other routes of infection occur only in certain high risk groups, eg drug users sharing infected needles or transmission from an infected mother to her baby. There is no evidence that the virus is transmitted by any other route. Normal social and employment contact with an infected person is safe for both employees and people who use the services as HIV is not spread through this kind of contact.

Implications of Equality Act

The Equality Act 2010 makes it illegal to discriminate on the basis of disability.

{{org_field_name}} understands that, according to the Equality Act 2010, it is unlawful to discriminate against disabled persons, including those with AIDS or HIV infection, in any area of employment. Furthermore, {{org_field_name}} understands that the law applies both to staff who are showing symptoms of their infection and those that do not. The Act protects people with progressive conditions against disability discrimination from the point at which symptoms have begun to have some adverse effect on a person’s ability to carry out normal day-to-day activities.

Public Health Guidance

This care service complies fully with all applicable health and social care best practice guidance on managing the risk of HIV transmission from infected workers to patients. While this risk is very low overall, the guidance states that it relates predominantly to what are referred to as “exposure prone procedures” or EPPs.

EPPs are defined in the guidance as those invasive procedures where there is a risk that injury to the worker may result in exposure of the patient’s open tissues to the blood of the worker. These include procedures where the worker’s gloved hands may be in contact with sharp instruments, needle tips or sharp tissues (eg spicules of bone or teeth) inside a patient’s open body cavity, wound or confined anatomical space where the hands or fingertips may not be completely visible at all times.

In this care service no such exposure prone procedures are performed. However, the service is aware that it may have to provide support to people who are undergoing such procedures.

The organisation understands that, according to the guidance, all new health care workers employed or starting training (including students) in a clinical care setting, either for the first time or returning to work in the NHS should undergo standard health checks which will include being offered an HIV antibody test.

Staff who suspect that they may be infected with HIV must cease any exposure prone procedures and seek expert advice from a specialist occupational health practitioner about modifications or limitations to their work practices. Effective occupational health monitoring arrangements and patient notification arrangements must be in place.

Responsibilities of the Organisation Towards Staff

Care staff should maintain and encourage an understanding attitude towards people with HIV/AIDS and prevent victimisation or discrimination against colleagues or people with HIV infection.
There will be no discrimination in recruitment against applicants internally or externally on the grounds that the applicant has HIV or AIDS and applicants who are deemed to be medically fit at the time of interview will not be rejected an offer of work because of AIDS.
Medical fitness will be determined through the normal recruitment process of requesting a medical and normal rules concerning sickness will be operated.
If it becomes known that an employee has AIDS, {{org_field_name}} will ensure that resources are available to provide adequate support and any reasonable arrangements or adjustments to enable work to be continued will be made on the grounds that to continue working may enable that person to maintain confidence and social contact and therefore fight AIDS with dignity.
No employee will be dismissed on the grounds that they have HIV infection or AIDS, or because they might be thought to be especially at risk. Where an employee becomes medically unfit to perform their duties they will be subject to current sickness procedures.
Employees will only be redeployed to alternative employment at their own request and will not be prevented from continuing work, except where they are deemed not medically fit through the standard procedures.
Consideration will be given to requests for special leave by those who have responsibility for caring for people with AIDS-related diseases.
No employee or applicant will be required to take the test for HIV antibody.
Any member of staff wishing to seek help regarding AIDS/HIV may do so through the manager or their Trade Union Representative and will be assured of complete confidentiality. If disclosure of information about an individual who has HIV or AIDS is necessary, it will only take place after authorisation has been sought from the person concerned.

Responsibilities of Staff

Staff have a duty and responsibility under s.7 of the Health and Safety at Work, etc Act 1974 and a professional and ethical responsibility, not to endanger, by their acts or omissions, the health of other employees or those in their care.
All staff are under an overriding ethical (and legal) duty to protect the health, safety and welfare of those in their care and should accordingly comply with this advice.
Staff who are involved in the clinical care of people should seek medical and occupational advice if they believe they have been exposed to infection from HIV-infected people using the services. Staff must remain under close medical supervision and receive appropriate medical and occupational advice as their circumstances change.
HIV-infected staff must not rely on their own assessment of the risk they pose to people but should promptly seek expert medical and occupational health advice.
There is no legal obligation for those staff who are infected with HIV, or who are suffering with AIDS or related conditions, to notify {{org_field_name}} of their condition. However, {{org_field_name}} would wish that all such staff did inform the manager so that appropriate confidential counselling, occupational health and staff support mechanisms can be put into place where required.
Staff will follow standard infection control procedures.

All staff should be aware that it is a criminal offence to dispose of dangerous and potentially infected waste in such a way as to pose a risk to others. This includes clinical waste and potentially infected sharp items such as needles and scalpel blades.

People Who Use the Services

In this care service:

no person will be denied care because they have AIDS or are antibody positive
{{org_field_name}} will regularly review all of its relevant practices and procedures to ensure that all users of services and all employees are adequately protected against HIV infection.

Needlestick Injuries Involving HIV

Any needlestick injury involving blood from a potentially HIV infected source should be dealt with according to the policy on needlestick injuries contained within the Disposal of Sharps Policy. In the event of an injury with a used or potentially contaminated needle, staff should:

wash the area immediately and encourage bleeding if the skin is broken
apply a dressing
report to the manager immediately and fill in an incident form
report immediately to a GP, Occupational Health Department or to an Accident and Emergency department.

There is a legal requirement under RIDDOR to report all occupationally-acquired needlestick injuries involving significant exposure to HIV positive material, to the Health and Safety Executive.

Confidentiality

Should the fact become known that an employee or receiver of services has the HIV virus then strict confidentiality will be maintained. Breaches of confidentiality will be dealt with in line with the service’s incident management and/or disciplinary procedures as appropriate.

This care service works on the principle that someone’s HIV status is to be disclosed at their discretion and it is unlikely that there will be a “need-to-know” basis for care workers and other staff.

People receiving services may or may not wish to disclose their status to people involved in their care. Where the service is made aware of someone’s HIV status then the assessor will ensure that the person’s confidentiality is respected, and that where necessary any boundaries are noted to avoid inadvertent breaches, such as if the person has not disclosed the information to other parties involved in their care, which could include their GP.

Should a person disclose their status to a care worker or other member of the team, the staff member should not assume this means the knowledge is common or public and should maintain confidentiality and discretion.

Where a person has informed their assessor, but does not wish to disclose their status to other staff and there is a chance that they would unintentionally recognise the situation (for example, due to the medicines they are supporting the person with) then this will be discussed with the person and the risk minimised as far as practicable (for example, by identifying a new compliance aid that would enable the person to take their medicines without support).

All records are stored in line with the service’s policies on confidentiality. This includes taking care with the records kept in the person’s home, ensuring they are not accessible to visitors.

Counselling

{{org_field_name}} recognises the important role of a counselling service for those who have AIDS or are antibody positive. For reasons of confidentiality and impartiality, {{org_field_name}} believes that this service should be provided by an external organisation. A co-ordinated approach to advice and counselling to those worried about HIV infection will however be developed between {{org_field_name}} and non-statutory organisations, social workers, GPs and other relevant workers or groups.

Training

In recognition that the fears and prejudices in relation to AIDS need to be addressed, a clear strategy of training and education must be developed including the production and presentation of material to help overcome negative reactions. This should be intended to overcome unfounded fears and prejudices, to promote good health and safety practices, to increase awareness of the necessary personal precautions and to promote awareness of the policy.

Infection control and AIDS/HIV should be included in the induction training for all new staff. All new clinical staff should be made aware of this protocol in their induction and all existing staff should be offered a regular refresher course in infection control and injection techniques.

Members of staff holding management posts will be expected to attend training courses on AIDS/HIV since they may be the first point of contact for those suffering from AIDS or HIV infection. In-house training sessions should be conducted annually and all relevant staff should attend. All staff should be made aware of the importance of the correct disposal of sharps and of clinical waste and of the part they play in the infection control process.

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}}

CH12. AIDS/HIV