Very poor knowledge of HIV among staff at major London hospitals

Moses Shongwe presenting to the BHIVA conference.

Knowledge of HIV transmission, ‘Undetectable = Untransmittable’ (U=U) and infection control is limited among nurses and other staff working on general hospital wards, Moses Shongwe of Barts Health NHS Trust told the virtual British HIV Association (BHIVA) conference yesterday. HIV-related stigma, particularly in healthcare settings, is a significant barrier to people accessing care, he said.

Staff working at St Bartholomew's Hospital, the Royal London Hospital and Newham Hospital were invited to fill out a brief questionnaire in December 2019 and January 2020. The 411 respondents were predominantly nurses (57%), healthcare assistants (19%) and doctors (12%) working in adult medical, surgical and critical care wards, accident & emergency and theatres.

Eighty per cent had not heard of U=U and 35% did not think that a person living with HIV can conceive and have children who are HIV negative.


Undetectable = Untransmittable (U=U)

U=U stands for Undetectable = Untransmittable. It means that when a person living with HIV is on regular treatment that lowers the amount of virus in their body to undetectable levels, there is zero risk of passing on HIV to their partners. The low level of virus is described as an undetectable viral load. 

needle-stick injury

Accidental injury with a needle or syringe used for injection.



Social attitudes that suggest that having a particular illness or being in a particular situation is something to be ashamed of. Stigma can be questioned and challenged.

infection control

Infection prevention and control (IPC) aims to prevent or stop the spread of infections in healthcare settings. Standard precautions include hand hygiene, using personal protective equipment, safe handling and disposal of sharp objects (relevant for HIV and other blood-borne viruses), safe handling and disposal of waste, and spillage management.

post-exposure prophylaxis (PEP)

A month-long course of antiretroviral medicines taken after exposure or possible exposure to HIV, to reduce the risk of acquiring HIV.

If they were treating a patient with HIV, 38% said they would feel at risk of HIV transmission. In the case of a needlestick injury from a patient with an undetectable viral load, 47% believed they would get HIV. Although 62% said they were aware of PrEP and PEP, 45% believed that in the event of a needlestick injury, they would need pre-exposure prophylaxis.

Three-quarters would not be confident discussing HIV status with a patient. A quarter would isolate HIV-positive patients in side-rooms and half thought they should be operated on at the end of the day, due to a risk of contamination.

Perhaps more encouragingly, 82% said they would like more information and training on HIV. The Barts HIV team say they are working on this: widespread educational programmes throughout the NHS trust could include a module as part of healthcare workers' induction. They suggest that other health organisations should conduct similar surveys.


Shongwe M et al. Measuring healthcare HIV knowledge within our NHS Trust. British HIV Association conference, abstract O06, November 2020.