Health care: exposure-prone procedures

Current UK Department of Health policy is for a total ban on HIV-positive healthcare workers performing exposure-prone procedures. As a result, a number of medical jobs are not open to people with HIV and the consequences for someone diagnosed in the middle of their career can be devastating.

An exposure-prone procedure is one in which injury to the healthcare worker could result in the worker’s blood contaminating the patient’s open tissues. These procedures involve a combination of sharps (scalpels, needles, etc.) and the worker’s hands being in a body cavity. Surgery is the most obvious example, but as the mouth is included as a body cavity, many dental procedures are defined as exposure-prone.

Procedures where the hands and fingertips of the worker are visible and outside the patient’s body at all times, as well as internal examinations or procedures that do not involve possible injury to the hands, are not considered to be exposure-prone.

HIV-positive healthcare workers are expected to seek occupational-health advice. However, all healthcare workers who are new to the NHS are offered a voluntary HIV test and, in the case of new workers who will perform exposure-prone procedures, this test is compulsory.[ref] ¹