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Guidance: Managing workers with HIV

3 February 2014

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Interim guidance has been released for managing doctors and nurses with HIV who perform exposure-prone procedures (EPPs). 

In August 2013 the Chief Medical Officer, Dame Sally Davies removed restrictions on healthcare workers with HIV performing EPPs. 

Such workers now have to sign up to a web-based register. 

The UKAP-OHR (UK Advisory Panel for Healthcare Workers Infected with Bloodborne Viruses – Occupational Health Monitoring Register for BBV Infected HCWs) will be available in April 2014. 

However, occupational physicians who wish to register an individual before April 2014 can use an interim paper-based registration system which can be downloaded from the Public Health England website

The guidance calls for HIV infected HCWs to meet the following criteria before they can perform EPPs: 


 a) be on effective combination antiretroviral therapy (cART), and 

 b) have a plasma viral load <200 copies/ml 


 c) be an elite controller.


 d) be subject to plasma viral load monitoring every three months. 

 e) be under joint supervision of a consultant occupational physician and their treating physician.

 f) be registered with the UKAP Occupational Health Monitoring Register (UKAP-OHR). 

The Public Health England guidance states: “Practising healthcare workers (HCWs) who undertake EPPs are under a professional duty to seek medical advice on the need to be tested as soon as they are aware they may have been exposed to HIV infection, occupationally or otherwise and if found to be positive, to obtain and follow appropriate clinical and occupational health advice. 

“Being HIV positive, or declining a test for HIV, will not affect the employment or training of HCWs who will not perform EPPs. 

The full interim guidance is available on the Public Health England website