Question

Can I still play rugby after being diagnosed HIV positive?

29 September 2010. Related: All topics, CD4 and viral load.

My CD4 count still remains low but viral load is undetectable. I know that the governing RFU rules state that any player must leave the pitch for attention due to any cuts/blood etc and would I need to disclose my status? Also would playing a contact sport lower my CD4 count further? Surely it is good for exercise/mental health/well being?

Answer

Answer: Charlotte Walker

Thank you for your question.

Let me start at the end and work backwards if that is ok? Your CD4 count will not be affected by your playing rugby. As you rightly said, exercise is a good way of maintaining a healthy body and mind which leads to a healthy immune system.

I contacted the RFU on your behalf and am pleased to say that they are very forward thinking. It is so refreshing to find an organisation that does not discriminate against people because of their HIV status but sticks to the facts of transmission and universal precautions! I have pasted their reply to your question below:

There are no regulations currently precluding HIV positive players from playing rugby union or mandating disclosure of their status to anyone. They may of course elect to disclose and the information will be handled according to the principles of medical confidentiality. All players are treated as if they might be carrying a blood borne disease when it comes to the management of bleeding wounds.

The RFU runs a medical helpline through RFU.com where advice on this type of issue can be sought on a confidential basis. We also provide guidance on blood borne viruses to rugby club first aiders through our first aid courses.

In general the advice to an individual would be:

1. Take advice in the first instance from their specialist.

2. If possible, to inform their club first aider, therapist and/or doctor, so that they can ensure that the appropriate infection control measures are adhered to. They will be bound by the principles of medical confidentiality.

3. Take the responsibility to strictly comply with the regulations on blood injuries and also, not share towels, shaving razors, flannels, or drink containers with other players.

Guidance on the risk and management of blood borne viruses in rugby has been provided to us on a general basis through the Health Protection Agency. Their advice has been;

• Based on scientific evidence to date, the risk of blood borne virus (BBV) transmission through  participation in sport is extremely low. Transmission outside sport is much more common.

• Not all persons infected with the virus, are infectious. There is currently therefore, no public health         basis for excluding a person from participation in any sport because of BBV infection. Participation should be determined by the athlete’s physician after medical evaluation of the seriousness of the illness.

• There is no medical or public health justification for routine BBV testing of participants in any sports activity.

• Adopting routine precautions to prevent the spread of infection is very effective. Consistent with routine, sound public health practice, all sports teams should employ universal precautions when providing first-aid or when cleaning-up blood or body fluids visibly contaminated with blood.

The IRB Laws and guidance to referees on the management of blood injuries form part of the risk reduction if there is a blood injury:

• All contaminated clothing and equipment must be replaced prior to the player being allowed to resume play.

• If bleeding should recur or come through a dressing, the player should be removed from the field of play for the dressings to be changed.

• If bleeding cannot be controlled and the wound securely covered, the player must not continue in the game.