HIV – let’s open our eyes

When I was spat on, through the wicket, from the back of the cell (great shot, pretty annoyed me though!), it was vile, I was disgusted, and the whole custody system ground to a halt whilst I got cleaned up and changed. That meant arrivals remaining in cuffs; detainees for release being delayed; and it stopped our officers getting back out on the streets where we belong. All in all, a very unpleasant experience which, amongst many other instances, is why I favour spit hoods.

Their procurement and issue has recently drawn a passionate debate from both sides of the argument, but we need to ensure there is balance in that discussion, and that we aren’t unnecessarily “frightening the herd” by inadvertently perpetuating myths. Let’s be honest, being spat upon is unpleasant enough to justify spit hoods with or without the added complexities of ailments.

There is a missed opportunity if limited training for officers around the realistic risks attached to blood-borne viruses is not improved upon, given the debate about spit hoods currently rages online, in the media and in canteens across the UK. In particular, and its something I’ve challenged before, the myth that we will contract HIV through spitting.

I’m not going to stray into discussing Hep C and others, because I don’t profess to know enough to lead an informed discussion – and I also accept that, with some people we deal with and come into contact with, they will have a whole range of medical challenges, some of which will of course overlap.  We should always take appropriate steps.

But, with HIV, there are some very specific nuances that I was surprised to learn of. For example, do you know what an “undetectable” viral load is? I didn’t! It’s someone with the HIV virus, whose count is so low that even through blood contact or unprotected sex (not whilst on duty, I presume) you are extremely unlikely to contract HIV? My naivety told me that once someone had HIV, best keep clear – I was wrong.

Retro-viral drugs, taken as prescribed, can suppress HIV to the extent it is sufficiently undetectable. However, this relies on medication adherence – taking the medication on time, every time. Where patients fail to take their medication, even for short periods (say, a weekend in custody), there is a risk the medication could fail to protect and suppress. With only a few types of retro-viral available, it mightn’t be long before no drug was effective. Notwithstanding the catastrophic impact that could have on the individual’s life-chances, we’ve just increased the risk to ourselves as well.

Yet, I can imagine circumstances where this could occur: a detainee, too embarrassed to say they have an illness whilst being booked in; or an officer too busy with paperwork and outstanding calls to go around to the home address to collect the medication promptly. Maybe the detainee has the medication with them, but it’s not in the wrapper because they don’t want people to know they have HIV, so we won’t allow them to take the mysterious blue pill. Sound familiar?

All of this likely happens every day, somewhere – we didn’t know, they didn’t say, nobody wanted to ask – but an entirely avoidable situation if we were all better educated by our Forces around blood-borne viruses, thus able to understand, relate and build a rapport with those we are dealing with.

I think that is a really important point. Parking the spitting issue, but I’ve witnessed, first hand, colleagues treating reasonably-behaved HIV-sufferers with a nervousness, simply because they don’t understand that shaking hands is not enough! Isn’t that an embarrassing state of affairs?

Hysteria around the risk, and lack of training on what is an awkward topic, clouds our judgement and affects how we treat others. We probably have colleagues with HIV, and it certainly doesn’t stop them undertaking all aspects of police work. The universal precautions we take when dealing with members of the public should be more than sufficient to safeguard against any risk of HIV without the need, for example, to double glove to take a set of fingerprints. Gloving up should be a rapid instinct in all circumstances.

Whilst not seeking to suggest there is no risk, ever – and I’ll reiterate there is the possibility, particular with some individuals who we regularly come into contact with, to have multiple illnesses or viruses – there remains a level of responsibility upon leaders and Forces to ensure we recognise how low the risk is when dealing solely with HIV.

After all, if I have an officer who has been spat on by someone – no matter how unpleasant that scenario is – why would I want them to be ill with worry, literally for months, when you cannot get HIV through spitting? It’s about perspective, and the risk of about being run over by a car isn’t enough to stop me crossing the road with care.

By improvements in our training, and better understanding the risks and likelihoods involved, coupled with being issued the appropriate protective equipment (i.e. gloves and spit hoods), alongside ready access to medical treatment that is both effective and available, we put ourselves in a strong position to offer immediate and longer-term care and welfare support to our colleagues when such incidents do occur.

Finally, I’d ask you to take a look at your Force’s infectious diseases policy (or equivalent) and compare it to the policy guidance issued by National Aids Trust (NATS) and the College of Policing, to ensure your Force is providing our colleagues with accurate and up-to-date information, which can be nothing other than a good thing. Being better informed isn’t to be sniffed at, and whilst we might still consider rushing to A&E each time, there is equally the chance that whether it’s one in a hundred or one in a thousand, a slightly better understanding helps build that rapport and avoids that spitting in the first place. One less colleague spat upon is a step in the right direction.

This blog was drawn from information provided on the National Aids Trust website, specifically in the June 2014 edition of HIV: A guide for police forces; and from the Terrence Higgins Trust website – both of which are UK charities aiming to remove the stigma attached to people suffering HIV.

If you have been affected by the content of this article, or for further information, please seek advice and support from either of the above charities, or from your Force Occupational Health service.