Worryingly low HIV knowledge among health workers at London hospital: 80% unaware of U=U, 36% worried about their risk from patients

Simon Collins, HIV i-Base

An oral presentation at BHIVA 2020 from Moses Shongwe from Barts Health NHS Trust showed disturbing low levels of HIV awareness from a recent survey of over 400 health workers at this major London hospital that provides expert HIV care.

The single-side 10-question paper survey was distributed to staff on adult medical, surgical and critical care wards, A&E and theatres at Barts NHS Trust on three days during December 2019 and January 2020.

The questions asked about confidence in treating people living with HIV, potential risks for health workers, and awareness of transmission, PEP, PrEP and U=U.

Overall, 411 surveys were returned from a wide range of professions: nurses (57%), Health assistants (19%), doctors (12%) but also including pharmacists, students and other workers. Approximately one-third were age 18-29, 30% were 30-39, 21% were 40-49 and the remainder >50 years old. Other demographics included 36% white, 29% black and 27% Asian, with 91% heterosexual.

The results in 2020 would actually have been alarming twenty years ago, especially coming from such a high incidence and high prevalence London borough.

Four in five people (80%) had not heard about U=U and almost half thought that a needlestick injury would be a risk from a patient with undetectable viral load. 35% still thought mother to child transmission was still a high risk with undetectable viral load.

Overall, 38% said they felt at risk when treating people living with HIV, 25% thought HIV positive patients should be isolated in side rooms, and 52% thought that HIV positive people should be placed at the end of operating lists

More than 3 in 5 (62%) had not heard of PEP or PrEP although 45% thought PrEP could be used after a needlestick injury and 76% were not confident at talking to patients about HIV.

The only positive results from the survey was that 82% of replies also asked for further information and training on HIV.


This short study showed such low levels of HIV awareness that it is difficult to know how to respond to the disturbing results.

Most people involved in HIV care hoped that the recent high profile given to PrEP and U=U would have reached the wider general public and certainly healthworkers in other fields.

This survey, especially if repeated in other trusts, shows such a low awareness that people living with HIV would very likely to receive suboptimal care. It also questions the recommendations for broad HIV disclosure to healthworkers outside of HIV.

They also highlight the real challenge for the ongoing Fast Track City to end HIV stigma in London.
  1. Shongwe M et al. Measuring health care HIV knowledge within our NHS trust. BHIVA 2020 virtual conference, 22-24 November 2020. Oral abstract O6.

This article was first posted on 22 November 2020.

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