Being an HIV positive nurse

Pacs, RN · Nov 23, 2011

The fact that a vaccine is available for Hep B doesn't mean you won't come accross unvaccinated patients. And your statement about the other hepatitis viruses is totally incorrect. You can contract Hepatitis C, E, G and TTV without already having hepatitis A or B. The only hepatitis virus that is exclusively co-infective is hepatitis D, which only occurs as co-infection or superinfection with hepatitis B. I'm afraid your facts are wrong. In any case, you singling out HIV in this way defies logic IMHO, as does ignoring the untested.

It is not uncommon to have a coinfection with hepatitis A and E.

In any case, I was simply making a point that we are discussing HIV here and not the other blood borne diseases. If you wish to discuss about those diseases, we can do so elsewhere on another thread and not here since this thread is just about HIV. Again, I am simply focusing on the topic presented in this thread and not the other issues that plague our profession. Don't get me wrong though, I completely understand your point.

Our arguments are becoming very circular so this will be my last post in this thread. However I will conclude by re-itearting that I believe you fall into a hysteria trap which stigmatises and punishes HIV positive nurses unneccessarily. There are seropositive health care personnel everywhere and do we hear of patient infection? Actually no, or extremely rarely. There was the case of the Spanish anaesthetist with Hep C who infected patients by injecting himself first and then injecting his patients with the same needle - that is a misconduct issue rather than a "being positive" issue. Sorry, but I find your reaction an over reaction, one you'd expect in the gutter press but not from supposedly informed heath care professionals.

I guess we'll have to agree to disagree. Doctors have different opinions regarding medical matters so it's only fair to have nurses having different opinions regarding nursing matters. If you think my reaction is an overreaction, then so be it (we obviously have very different opinions regarding what constitutes an overreaction) but I am entitled to my opinion. Personally, if I found out that I am positive with HIV, I'll gladly leave the profession to reduce the risk of myself infecting my patients. That being said, it doesn't mean I'll avoid a person who has HIV and run as if the disease spreads through the air or upon contact. I'll greet one walking in the street and shake their hands. But a person with HIV spitting or holding something sharp? Well, that's another story.

Positive Attitude · Nov 23, 2011

We handle needles and body fluids in our line of work. Until a cure or a vaccine is developed, perhaps other fields in nursing will be much more appropriate. Perhaps those that do not involve bedside care and handling of body fluids?
Again, it's the welfare of our patients that I am thinking about. The risks are just too great even with proper preventive measures. (You never know when accidents could happen)

Erm, handling body fluids is a potential risk to the health worker rather than the patient, surely?

There are a small number of specific procedures that health workers with certain infections (including HIV) should probably not carry out. Suturing, for example. But to put a blanket ban on all nurses with HIV from being involved in direct patient care sounds like out and out descrimination if you ask me.

I have been a nurse for 26 years and HIV positive for 25 of them and I can assure you that absolutely NO patient has ever been put at risk by me.

Pacs, RN · Nov 25, 2011

Erm, handling body fluids is a potential risk to the health worker rather than the patient, surely?
There are a small number of specific procedures that health workers with certain infections (including HIV) should probably not carry out. Suturing, for example. But to put a blanket ban on all nurses with HIV from being involved in direct patient care sounds like out and out descrimination if you ask me.
I have been a nurse for 26 years and HIV positive for 25 of them and I can assure you that absolutely NO patient has ever been put at risk by me.

Well now, what you have said is a great compromise if you ask me. Good for you. What concerned me the most was us handling sharp needles in the first place. With a nurse like you, I'm now certain our patients will be safe from the spread of this virus. Thank you Positive Attitude. :up:

czyja, MSN, RN · Nov 30, 2011

Provider to patient transmission appears to almost non-existent in the developed world. The one or two cases that may have happened were in a surgical setting. There is no evidence (to my knowledge) that suggests HIV+ nurses cannot safely practice.

Patient to provider transmission is, however, a very real risk.

Here is a link to an excellent editorial on this subject in the Annals of Internal Medicine by Julie Gerberding.

http://www.annals.org/content/130/1/64.full

Pacs- I welcome any contrary evidence you might have.

Pacs, RN · Nov 30, 2011

Provider to patient transmission appears to almost non-existent in the developed world. The one or two cases that may have happened were in a surgical setting. There is no evidence (to my knowledge) that suggests HIV+ nurses cannot safely practice.
Patient to provider transmission is, however, a very real risk.
Here is a link to an excellent editorial on this subject in the Annals of Internal Medicine by Julie Gerberding.
http://www.annals.org/content/130/1/64.full
Pacs- I welcome any contrary evidence you might have.

Interesting article, czyja. However, I'd like to quote a line from that article: "Despite a very thorough investigation, the mechanism and date of transmission could not be established with certainty, and the patient had had dental care in a region where HIV is highly prevalent before her infection was documented." Which means that the results of the study is not without its loopholes. Nevertheless, we must not forget that the Human Immunodeficiency Virus can remain dormant for years before it can be detected by standard screening. Also, the cost of advanced procedures to detect HIV infection with certainty can be very impractical.

Still, I have to agree that with proper precautions, one can prevent transmissions risks at about 3-1% (again, still not zero). Also worth noting that while the study may be true for developed countries, the same may not be true for underdeveloped countries where clinical settings are......less than ideal. In any case, I already agreed with Positive Attitude's compromise regarding certain specific procedures a nurse with an HIV infection should not carry out. So I don't think it's of any issue anymore.