UK to lift ban on HIV positive health workers who are on ART with undetectable viral load

Simon Collins, HIV i-Base

On 15 August 2013, the UK Department of Health announced important changes in the regulations that previously restricted HIV positive people from working in some healthcare jobs, specifically some dental and surgical procedures. [1]

The announcement included information that: “Strict rules on treatment, monitoring and testing will be in place to safeguard patients”.

The press statement noted that: “… the change will bring the UK in line with most other Western countries. Under the new system, patients will have more chance – around one in five million – of being struck by lightning than being infected with HIV by a healthcare worker.”

The changes have the potential to reduce this risk further if it prompts healthcare workers to be tested.

Each case will be decided individually and will only be considered if an HIV positive healthcare worker has an undetectable viral load on ART and is being routinely monitored.

The policy will be in place from April 2014. Public Health England will now put in place a programme to register and monitor healthcare workers who have HIV and ensure they are able to perform certain procedures when appropriate.

The statement noted that: “There is no record of any patient ever being infected through this route in the UK” and went on to list the only four documented cases reported worldwide:

  • A dentist in Florida (USA), who transmitted HIV to six patients (reported in 1992).
  • An orthopaedic surgeon in France who transmitted HIV to one patient during a hip operation (reported in 1999).
  • An obstetrician and gynaecologist in Spain who transmitted HIV to one patient during a Caesarean section (reported in 2003).
  • An additional case of HIV transmission by a nurse in France, where the route of transmission is still unclear (reported in 2000).

In a statement from BHIVA, chair Dr David Asboe, said “BHIVA welcomes the relaxation of the ban on healthcare workers infected with HIV working on certain dental and surgery procedures. This reflects increased confidence in the effectiveness of antiretroviral treatment in reducing viral levels and resulting infectiousness.” [2]


  1. Department of Health. Modernisation of HIV rules to better protect public. (15 August 2013).
  2. BHIVA press release. British HIV Association (BHIVA) response to Department of Health announcement ‘Modernisation of HIV rules to better protect public’. (15 August 2013).

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