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SL56-HIV Awareness and Support Policy

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Registration Number: {{org_field_registration_no}}

HIV Awareness and Support Policy

1. Purpose

This policy sets out how {{org_field_name}} promotes HIV awareness, prevention, confidentiality, equality, safety and person-centred support within its supported living services in England. It explains how the organisation will support people living with, affected by, or at risk of HIV in a way that protects their dignity, privacy, autonomy, human rights and wellbeing.

The purpose of this policy is to ensure that no person is discriminated against, stigmatised, excluded, treated less favourably, or denied access to housing-related support, care, employment, activities, opportunities or services because they are living with HIV, perceived to be living with HIV, associated with someone living with HIV, or because they choose not to disclose their HIV status.

This policy supports compliance with the Health and Social Care Act 2008, the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, CQC Fundamental Standards, the Equality Act 2010, the Care Act 2014, the Mental Capacity Act 2005, UK GDPR, the Data Protection Act 2018, and current infection prevention and control guidance for adult social care in England.

The organisation will promote a stigma-free, inclusive and evidence-informed approach to HIV. Staff must understand that HIV cannot be transmitted through ordinary day-to-day contact, sharing accommodation, sharing toilets or bathrooms, eating together, touching, hugging, social contact, coughing, sneezing, or sharing household items.

2. Scope

This policy applies to all directors, nominated individuals, registered managers, managers, employees, agency workers, bank staff, volunteers, students, contractors and any other person working on behalf of {{org_field_name}}.

It applies to all people using the service, including people living with HIV, people affected by HIV, people who may be at increased risk of HIV, and people who choose not to disclose their HIV status.

In supported living, people have their own tenancies, licences or occupancy agreements. Staff must respect each person’s home, privacy, choices, relationships and independence. This policy applies only to the care and support delivered by {{org_field_name}} and does not give staff or the organisation authority to restrict a person’s ordinary rights as a tenant or occupier.

Where {{org_field_name}} provides personal care, the service must be registered with CQC for the regulated activity of Personal Care unless a specific exemption applies. The organisation must ensure that the care and support it provides matches the regulated activities, locations, conditions and statement of purpose registered with CQC.

3. Legal Framework

This policy is underpinned by the following legislation, regulations and guidance:

The organisation will also consider CQC’s current assessment framework and quality statements under the five key questions: safe, effective, caring, responsive and well-led.

4. HIV Awareness and Prevention

HIV awareness is essential to safe, effective, inclusive and non-discriminatory supported living. {{org_field_name}} will ensure that staff receive clear, evidence-informed information about HIV transmission, prevention, testing, treatment, confidentiality and stigma.

Staff must understand that HIV is not transmitted through normal social or household contact. Staff must not isolate, exclude, restrict, label, shame, disclose information about, or apply unnecessary infection control measures to a person because they are living with HIV or are perceived to be living with HIV.

The organisation will promote access to reliable information and appropriate health services, including local sexual health services, GP services, NHS 111, HIV specialist services, community HIV organisations, and local public health resources. Staff may signpost people to information about HIV testing, PrEP, PEP, condoms, safer sex, harm reduction, treatment adherence and peer support where this is relevant to the person’s wishes, needs, risks or support plan.

HIV testing must always be voluntary, confidential and based on informed consent. Staff must not pressure a person to have an HIV test, disclose their HIV status, share sexual health information, or accept HIV-related support. Where a person requests support to arrange testing or treatment, staff will provide practical assistance in a respectful and confidential way.

Where a person may have been exposed to HIV, staff must treat the matter sensitively and urgently. Staff should support the person to access clinical advice without delay, including urgent sexual health, NHS 111, emergency department or occupational health advice as appropriate. Staff must not give clinical advice beyond their role.

The organisation recognises the Government’s ambition to end new HIV transmissions in England by 2030 and will support prevention, testing, treatment access, stigma reduction and good quality of life for people living with HIV.

5. Confidentiality and Non-Discrimination

HIV status is private, confidential health information and is special category personal data under UK GDPR and the Data Protection Act 2018. Staff must not ask a person to disclose their HIV status unless there is a clear, lawful, necessary and proportionate reason connected to the person’s care and support, risk assessment, medicines support, or emergency health needs.

A person is not required to tell staff, other service users, landlords, neighbours, visitors, contractors or other professionals that they are living with HIV. Where a person chooses to disclose their HIV status, staff must respond respectfully, thank the person for trusting the service, explain how the information will be recorded and protected, and ask who, if anyone, the person consents for the information to be shared with.

HIV-related information must only be shared where there is a lawful basis, a clear need to know, and either the person has given valid consent or there is another lawful justification, such as a serious safeguarding concern, medical emergency, or legal requirement. Any disclosure must be limited to the minimum necessary information and recorded with the reason for sharing.

Staff must not discuss a person’s HIV status in communal areas, staff rooms, handovers where it is not relevant, public spaces, shared offices, electronic messages, or with people who do not need the information. Records containing HIV-related information must be accurate, respectful, factual, secure, access-controlled and retained in line with the organisation’s Data Protection and Record Keeping Policies.

Discrimination, harassment, victimisation, bullying, gossip, jokes, exclusion, refusal of support, unnecessary use of PPE, unnecessary segregation, or different treatment because of HIV status, perceived HIV status, disability, sexual orientation, gender identity, race, sex or any other protected characteristic is prohibited. Any breach will be managed through safeguarding, complaints, disciplinary, data breach and duty of candour procedures as appropriate.

6. Support and Reasonable Adjustments

People living with HIV must receive person-centred support that reflects their individual needs, wishes, strengths, communication needs, protected characteristics, cultural needs, relationships, health goals and preferred level of privacy.

Where a person tells the service that they are living with HIV, staff must ask what support, if any, the person wants. Support may include help to arrange or attend appointments, reminders to take medication where this is part of the agreed support plan, emotional support, support to access peer support or advocacy, support to maintain routines, help to understand health information, or reasonable adjustments to the way care is delivered.

Any HIV-related support must be included in the person’s care and support plan only where this is necessary, proportionate, agreed with the person, and recorded respectfully. The care plan must not include unnecessary detail about the person’s diagnosis, sexual history, relationships or treatment unless this is relevant to the support being provided and the person has consented or there is another lawful basis.

Reasonable adjustments may include flexible appointment support, private spaces for conversations, accessible information, communication support, culturally appropriate support, support with digital or telephone appointments, support with medicines routines, or changes to staff approach to reduce anxiety, stigma or distress.

Staff must promote independence and choice. Living with HIV must not be used as a reason to restrict ordinary activities, relationships, employment, education, community access, shared living, food preparation, laundry, use of communal areas, visitors, intimacy, travel, or social participation.

7. Health and Safety Considerations

{{org_field_name}} will apply standard infection prevention and control precautions consistently for all people, regardless of known or perceived HIV status. Staff must not apply additional precautions solely because a person is living with HIV unless advised by a competent health professional for a specific clinical reason.

Staff must follow the organisation’s Infection Prevention and Control Policy, Health and Safety Policy, COSHH procedures, waste disposal arrangements, sharps procedures, first aid procedures, cleaning procedures and incident reporting procedures. Standard precautions include hand hygiene, appropriate use of PPE, safe handling and disposal of sharps, safe management of blood and body fluid spillages, safe cleaning, safe laundry practice where support is provided, and safe disposal of clinical or contaminated waste where applicable.

Where there is a blood or body fluid exposure incident, including needlestick injury, bite injury involving blood, splash to broken skin, eyes or mucous membranes, or other significant exposure, staff must:

  1. provide immediate first aid in line with training;
  2. report the incident to the manager immediately;
  3. seek urgent medical, occupational health, NHS 111 or emergency department advice as appropriate;
  4. record the incident accurately;
  5. maintain confidentiality;
  6. review the incident to identify learning and prevention measures.

PEP may be time-critical following possible HIV exposure. Staff must not decide whether PEP is required; this decision must be made by an appropriate healthcare professional. The role of staff is to support urgent access to clinical advice.

The organisation will ensure that infection prevention and control arrangements are proportionate to the service being delivered in supported living and reflect current adult social care guidance. Providers registered with CQC must comply with the regulations and consider the infection prevention and control Code of Practice when delivering services.

8. Consent, Capacity and Choice

Staff must seek valid consent before providing HIV-related support, sharing HIV-related information, arranging appointments, supporting testing, discussing sexual health, supporting medication routines, or involving other professionals, unless there is a lawful reason to act without consent.

A person must be presumed to have capacity to make their own decisions unless it is established that they lack capacity for a specific decision at the specific time it needs to be made. A person must not be treated as lacking capacity simply because they make a decision that others consider unwise.

Where there is concern that a person may lack capacity to make a specific HIV-related decision, staff must follow the Mental Capacity Act 2005 and the organisation’s Consent and Mental Capacity Policy. Any best interests decision must be the least restrictive option, involve the person as far as possible, consider their wishes, feelings, beliefs and values, and involve appropriate representatives or professionals.

Staff must respect the person’s right to private and family life, relationships, sexual expression and autonomy. Staff may provide information and support to reduce risk, but must not control, shame, threaten or restrict a person because of their HIV status or sexual health choices.

9. Managing HIV in Supported Living Settings

Supported living services must promote independence, privacy, dignity, equality, safety and community inclusion. A person’s HIV status must not be used to restrict their tenancy rights, daily routines, relationships, visitors, access to communal areas, food preparation, laundry, activities, work, education, volunteering or community involvement.

Staff must support people in a way that is led by the person’s wishes and agreed support plan. Where a person wants support with HIV-related needs, this may include confidential emotional support, support to access healthcare, support to attend appointments, support with medication routines where this is included in the support plan, support to understand accessible information, or signposting to specialist HIV or sexual health organisations.

Staff must not disclose a person’s HIV status to landlords, housing providers, other tenants, family members, friends, visitors, neighbours, contractors or other professionals unless the person has consented or there is a clear lawful basis.

Where staff identify stigma, bullying, harassment, abuse, coercion, exploitation, domestic abuse, hate incidents or discriminatory behaviour linked to HIV status, perceived HIV status, sexuality, gender identity, disability, race or any other protected characteristic, they must report this under the organisation’s safeguarding and incident reporting procedures.

The organisation will work in partnership with the person, and where appropriate with GPs, HIV clinics, sexual health services, pharmacies, community nurses, social workers, advocates, local authority commissioners and voluntary sector organisations, while maintaining confidentiality and consent.

10. Safeguarding, Abuse, Exploitation and Hate Incidents

HIV-related stigma, coercion, threats to disclose HIV status, bullying, harassment, sexual exploitation, domestic abuse, discriminatory abuse, hate incidents and neglect may be safeguarding concerns. Staff must remain alert to signs that a person is being abused, controlled, isolated, exploited, blackmailed, threatened or treated unfairly because of HIV status, perceived HIV status, sexuality, gender identity, disability, race or any other protected characteristic.

Any safeguarding concern must be reported immediately in line with the organisation’s Safeguarding Adults Policy and local safeguarding procedures. Staff must record concerns accurately, preserve confidentiality as far as possible, and share information only where necessary and lawful to protect the person or others from abuse or serious harm.

Staff must support the person’s wishes and desired outcomes wherever possible, in line with Making Safeguarding Personal. However, staff must escalate concerns where there is risk of serious harm, coercion, abuse, exploitation, organisational abuse, or risk to others.

Where the concern may involve a criminal offence, hate crime, domestic abuse, sexual violence, exploitation or modern slavery, the manager must consider whether police, local authority safeguarding, health professionals or other specialist agencies need to be involved.

11. Training and Education

All staff will receive HIV awareness information appropriate to their role. Training and guidance will cover:

Training must be refreshed at intervals set by the organisation’s training matrix and sooner where legislation, guidance, local procedures or identified learning changes. Managers must monitor training completion and staff competence through supervision, observations, competency checks, team meetings, audits and reflective learning.

Where staff provide regulated activity, the organisation will ensure that staff are suitably qualified, competent, skilled and experienced for their role. The organisation will also ensure compliance with mandatory learning disability and autism training requirements where applicable to staff roles.

12. Medicines Support

Where a person living with HIV receives support from {{org_field_name}} with medicines, this must be provided in line with the person’s assessed needs, consent, care and support plan, Medicines Policy, MAR procedures and staff competency.

Staff must not make assumptions about a person’s HIV treatment or ask intrusive questions. Where medication support is agreed, staff must support the person discreetly and respectfully. This may include prompts, reminders, collection support, storage support, appointment support, or recording support, depending on the person’s care plan and the organisation’s medicines procedures.

Staff must maintain confidentiality when handling, storing, recording or discussing HIV medication. Medication names, packaging, pharmacy labels, MAR charts and appointment letters must not be left visible to people who do not need to see them.

Any missed doses, refusal, side effects reported by the person, difficulty obtaining medication, or concern about adherence must be recorded and escalated in line with the Medicines Policy and with the person’s consent where required. Staff must seek advice from the person’s pharmacist, GP, HIV clinic or other healthcare professional where appropriate and within the limits of confidentiality and consent.

13. Reporting Concerns, Complaints and Duty of Candour

Any person using the service, staff member, family member, advocate, professional or representative may raise a concern or complaint about discrimination, confidentiality breaches, stigma, unsafe practice, poor support, staff conduct, information sharing, privacy, safeguarding, or any other issue linked to this policy.

Complaints and concerns will be handled in line with the organisation’s Complaints Policy. The organisation will ensure that complaints are taken seriously, acknowledged, investigated proportionately, responded to openly, and used to improve practice. People must not be treated unfairly or victimised because they raise a concern or complaint.

Where a complaint or concern indicates abuse, neglect, discriminatory abuse, hate incident, data breach, health and safety incident, medicines incident, or breach of confidentiality, the manager must also follow the relevant safeguarding, incident reporting, data protection, disciplinary, duty of candour and notification procedures.

Where a notifiable safety incident occurs, the organisation will comply with the duty of candour by acting in an open and transparent way, providing a truthful account, apologising where required, explaining actions taken, and keeping records.

Where an incident meets CQC statutory notification thresholds, the registered manager or nominated person must submit the relevant notification to CQC in line with the Care Quality Commission (Registration) Regulations 2009.

14. Monitoring, Audit and Review

The registered manager is responsible for ensuring this policy is implemented, monitored and reviewed. Compliance will be monitored through governance systems including, where relevant:

The organisation will use audit findings, incidents, complaints, safeguarding concerns, feedback and changes in guidance to improve practice. Learning will be shared with staff through supervision, team meetings, training, policy updates and quality assurance processes.

This policy will be reviewed annually, or earlier if there are changes to legislation, CQC guidance, public health guidance, local safeguarding procedures, organisational structure, regulated activity, or identified risks.

15. Roles and Responsibilities

The provider, nominated individual and registered manager are responsible for ensuring that this policy is implemented, resourced, monitored and reviewed.

The registered manager is responsible for ensuring that staff understand the policy, receive appropriate training, follow confidentiality and safeguarding procedures, and provide person-centred support to people living with or affected by HIV.

Managers and senior staff are responsible for responding promptly to concerns, complaints, incidents, safeguarding issues, data breaches, discrimination, staff conduct concerns and practice issues linked to this policy.

All staff are responsible for treating people with dignity and respect, maintaining confidentiality, following infection prevention and control procedures, challenging stigma, reporting concerns, recording accurately, and working within their role and competence.

Staff must seek advice from a manager where they are unsure how to respond to HIV-related information, risk, confidentiality, safeguarding, medicines, consent or capacity issues.

16. Records and Information Governance

All records relating to HIV status, HIV treatment, sexual health, testing, medication, appointments, support needs or related risks must be factual, respectful, necessary, proportionate, accurate and securely stored.

The organisation will ensure that access to HIV-related information is restricted to staff who need the information to provide safe and appropriate care and support. Staff must not access records out of curiosity or share information informally.

Where HIV-related information is shared with another professional or agency, staff must record what was shared, with whom, when, why, the lawful basis, and whether the person consented.

Any suspected or actual breach of HIV-related confidentiality must be reported immediately to the manager and handled in line with the Data Protection Policy, Information Governance Policy, disciplinary procedures and, where applicable, ICO reporting requirements.

17. Partnership Working and Signposting

With the person’s consent, and where relevant to their care and support, {{org_field_name}} may work with GPs, HIV clinics, sexual health services, pharmacists, community nursing teams, social workers, advocates, mental health services, local authority commissioners, safeguarding teams and voluntary sector HIV organisations.

Staff must support people to access reliable information and services but must not provide clinical advice, diagnose conditions, interpret test results, recommend treatment, or make decisions about PrEP, PEP or antiretroviral therapy. Clinical advice must come from appropriately qualified healthcare professionals.

Where a person requests HIV-related information, staff should use reputable sources such as NHS, UKHSA, DHSC, local sexual health services, HIV clinics or recognised HIV charities.

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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