We CXR and heaf test anyone who has come from a TB high risk area in the
last 5 years. It happens to be the case that a lot of high risk TB areas
also have high HIV rates. If the heaf test is negative it's possible it
could be because they are immunocompromised and we do strongly recommend
that they attend the GU clinic for HIV testing. We have had at least one
case where someone with a negative heaf actually was TB and HIV positive.
However with appropriate treatment and sick leave this person did
successfully return to work. The point I am making is that occasionally a
heaf test can inadvertantly tell you something else!
----- Original Message -----
From: "Glenn Raybone" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Wednesday, February 11, 2004 1:43 PM
Subject: HIV testing
> Hello all,
>
> can I put a real ethical question to you, especially my NHS colleagues?
>
> We undertake screening for an organisation that provides health care
> workers throughout various care organisations. A large majority of these
> HCW's have come into the UK from South Africa where I believe the
> prevalence of HIV infection is approximately 1 in 3. However we do not
> offer HIV testing at pre-employment. Now comes the difficult bit!
>
> The draft document 'Health Clearance for Serious Communicable Diseases:New
> Health care Workers' has not really helped as it seems nothing further has
> moved with this document.
>
> Whilst we test for TB immunity from an endemic country, can or should the
> same apply to a country where the incidence of HIV is so high? Could this
> be seen as having racial undertones? Is it discriminating?
>
> Obviously any HCW has a moral and ethical duty and obligation to notify
> such infections, but there have been cases where a questionnaire is full
> of 'no' answers yet the truth is somewhat different.
>
> I have no real thoughts on what would be ideal here, and just wanted to
get
> a flavour of what others think or do.
>
> Look forward to hearing from you,
>
> regards,
>
> Glenn Raybone
>
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