U=U and partner notification A case discussion Maeve Cross Senior Health Adviser GUM RVH Belfast

Living in Northern Ireland Julia Ex - RMP ? 3 yr old 11 yr old 9 yr old Living in England Living in Northern Ireland

Factors influencing case

I would be concerned about her safety There is no need to pursue the issue of partner notification I’ve had legal advice and have been told he has a right to know What if he finds out about the HIV and we get sued? If we know who he is let’s just get him tested Surely, he has a right to know?

Factors impacting on health advisers decision making Rank and Power within MDT

What other guidance can we look to ? Management of patients following exposure to blood and body fluid of HIV infected HCW “If the exposure was judged to be significant and the HCW has a stable low viral load (less than 200 copies/ml), neither PEP nor follow-up HIV testing of the patient is necessary” “Where there is a concern that the viral load might be detectable (above 200 copies/ml), the HCW’s viral load should be tested immediately, PEP should be offered to the patient pending the result…”

Conversations with Julia “I am frightened how he will react (if he finds out about my HIV” “He has told me he will get the child and I can go back to Thailand” “They will try and say in court that because of HIV I can’t look after my child” “Maybe it is good if someone contacts him and then he can get a test” “You can’t use the number that I use to call him, cos he will know that I gave it to you”

Useful to consider… What does your group think about case? What might you have done differently and why? What does this case bring up for you?