Medical professionals refuse surgery for people living with HIV, research finds

Aoífe Commins, a Galway nurse living with HIV, welcomed the new project, RISE (Redefining Institutional Stigma Education), that offers training for healthcare workers on HIV stigma and its impact for patients. Photo: Hany Marzouk

People living with HIV have been refused surgery, put last on waiting lists and are still stigmatised by many in the medical profession as drug users, new Irish research has found.

Some 76% of doctors, nurses and other healthcare workers including medical students have seen discrimination from their colleagues towards these patients, the Royal College of Surgeons Ireland University of Medicine and Health Sciences has found.

Responses included "anecdotes about the refusal to carrying out surgical procedures, reluctance to take blood samples, placing individuals last for procedures, and changing an individual’s resuscitation status for patients with HIV". 

Discrimination also includes staff using unnecessary double gloving and the overuse of PPE as well as assumptions such as patients are sexually promiscuous.

One nurse said they have seen “several instances of healthcare providers refusing to perform surgical procedures on patients after they learn their HIV status, being quick to change resuscitation statuses on young patients on which they normally wouldn’t, nursing staff wearing gloves when touching patients, contact precaution signs put on room doors of patients with HIV on wards". 

A doctor said in their experience healthcare workers assume “someone is carrying out risky behaviours, e.g. intravenous drug use, upon finding out that they have HIV”.

Participants were asked to rank diseases as most and least stigmatised against, with 85% putting HIV as either the first or second most stigmatised against.

They indicated patients even feel unsure about telling healthcare workers they have HIV due to fears of a negative reaction. Patients also worry their disclosure will not be treated confidentially.

RCSI also identified a lack of knowledge about HIV with only 45% having done additional training since starting work, although many would like this chance.

RISE (Redefining Institutional Stigma Education)

This comes as a new project was launched on Tuesday offering training for healthcare workers on HIV stigma and its impact for patients — called RISE (Redefining Institutional Stigma Education).

Aoife Commins, a Galway nurse living with HIV, welcomed the project.

“I think it’s important that our voices are included in the education of healthcare students and workers going forward so we are no longer stigmatised in a setting where we should feel most understood,” she said.

Dr Eoghan de Barra, consultant in infectious diseases at Beaumont Hospital and senior lecturer at RCSI pointed out: “There was a 68% marked increase in the total number of people diagnosed with HIV in Ireland in 2022."

This means, he said, more and more healthcare workers will have people living with HIV as patients. This highlights the “importance of ensuring all healthcare providers, regardless of role, are able to create a stigma-free environment for their patients,” he urged.

Project lead Dr Amir K. Bachari warned “the enduring toll of HIV stigma persists” and they hope to address this.

RISE is supported by Gilead Sciences Fellowship Grant and through resources made available by RCSI, including the Student Engagement and Partnership (StEP) fund.