Page 41 - Garda Journal Summer 2019

FEATURE | HIV
HIV On The Thin Blue Line
By Noel Donnellon. Noel is a member of ACT UP Dublin and recently completed HIV Science MOOC with Institut Pasteur, Paris, France.
“Protecting our police officers in their work includes protecting them from needless anxiety”, explains Matthew Hodson, Executive Director of NAM which works to change lives by sharing information about HIV. “It is impossible to acquire HIV from spitting, even if there is blood in the spit. This does not mean that being spat on at work is acceptable. It does mean that, if someone spits at a police officer, there is no need for them to be concerned about HIV infection. Perpetuating the idea that spit can transmit HIV will only serve to increase their distress.”
Findings from HIV Ireland’s “HIV in Ireland 2017” survey are cause for concern. When asked about knowledge of HIV transmission 32% of respondents incorrectly reported that they thought HIV can be passed from person to person by spitting, 11% thought it can be passed through a cough or sneeze, 24% thought by kissing and 10% by sharing a glass. None of these are possible.
Even theoretical and extremely low risk transmission routes are not well understood. In the findings 84% thought HIV can be passed by standing on a used needle. Although a theoretical risk, there have been no reported cases of HIV transmission that way outside of a healthcare setting. Likewise HIV transmission from biting is extremely rare and has happened only in cases where blood was present in the biters mouth. There is no risk of transmission if the skin isn’t broken.
When there is a genuine cause for worry, Post Exposure Prophylaxis (PEP)—a month-long course of anti-retroviral drugs—can be started within 72 hours of a potential HIV exposure. PEP is extremely effective in protecting someone from possible transmission and is available for free in most STI/GUM clinics and Hospital Emergency Departments.
To put the need for PEP in biting cases in perspective, the Health Protection Surveillance Centre (HPSC) Emergency Management of Injuries and Post-exposure Prophylaxis toolkit for PEP comments “to date there
have only been a handful of reports of [blood- borne virus] transmission from human bites and few of these were convincing. All cases involved deep bites where there was blood in the mouth of the biter, and where the biter had high viral loads. thus the absolute risk is not known - deemed to be possible but extremely rare.”
There is an obligation in court by anyone giving evidence not to intentionally misinform the jury with false or exaggerated statements and also a duty by barristers and justices to call out bad science in general. Untrue statements regarding HIV reinforce entrenched stigma for all people living with HIV (PLWHIV) the vast majority who are law abiding. As far back as 2010 Ms Justice Mary Irvine ruled that there is a lack of
knowledge among members of An Garda Síochána about how HIV, Hepatitis B and Hepatitis C are transmitted yet statements still emerge on a regular basis in court and of course many court reporters and journalists run with sensationalist and untrue headlines compounding the stigma for people living with HIV.
There have even been incorrect comments regarding HIV tests and the window period some referring to a wait of six months. A 4th generation laboratory test— the kind performed when you have blood drawn—can diagnose most HIV infections in about 4 weeks, and can provide a definitive result in 12 weeks.
Disclosure of a person’s HIV status should never be done non-consensually and in general Gardaí are good on that matter. However 4% of respondents to the previously referred to attitudes and stigma surveys showed that they had their HIV status accidentally disclosed by the Gardaí.
The realities of HIV and people living with HIV in Ireland today compared to in the 1980s and 90s, are worlds apart. Today for example, we know that when a person living with HIV is on effective treatment there is no risk of transmission sexually. HIV medication also protects HIV-negative people when used as PEP or PrEP (pre exposure prophylaxis). Understanding HIV transmission routes and genuine risk or lack thereof is vital for police officers worldwide and knowledge can help reduce stigma for people living with HIV.
Reducing stigma benefits society as a whole. As HIV Ireland’s executive director, Niall Mulligan recently commented on UNAIDS Zero Discrimination Day: “It is crucial for policy makers and politicians to understand the impact that stigma and discrimination is having on people. Negative, or misinformed attitudes to HIV, and towards people living with HIV, can create obstacles for people getting tested, and prevent them from accessing the support they need.”
www.actupdublin.com
GARDA JOURNAL 41