World Health Organisation, International Labour Organisation, UNAIDS
Publication Date: November 1, 2010
Joint guidelines aimed at protecting, retaining, and empowering healthcare workers in dealing with the dual threat of HIV and tuberculosis (TB) infection, based on a systematic literature review, an assessment of current practices in 21 countries, and the results of consultations with international experts and organisation constituents. Topics addressed include: introducing new national policies or refining existing policies that ensure priority access for healthcare workers and their families to services for the prevention, treatment, care, and support for HIV and TB; introducing new policies or reinforcing existing policies that prevent discrimination against healthcare workers with HIV or TB and adopting interventions aimed at stigma reduction among colleagues and supervisors; establishing schemes for reasonable accommodation and compensation including, as appropriate, paid leave, early retirement benefits, and death benefits in the event of occupationally acquired disease; developing, strengthening, or expanding existing occupational health services for the entire healthcare workforce so that access to HIV and TB prevention, treatment, care, and support can be attained; developing or strengthening existing infection control programmes, especially regarding TB and HIV infection control, and collaborating with workplace health and safety programmes to ensure a safer work environment; developing, implementing, and extending programmes for regular, free, voluntary, and confidential HIV counselling and testing, and TB screening, including addressing reproductive health issues, as well as intensified TB case finding in the families of healthcare workers with TB; identifying, adapting, and implementing good practices in occupational health and the management of HIV and TB in the workplace in both public and private healthcare sectors, as well as other sectors; providing information on benefits and risks of postexposure prophylaxis to all staff and provide free and timely postexposure prophylaxis for all exposed healthcare workers, ensuring appropriate training of postexposure prophylaxis providers; providing free HIV and TB treatment for healthcare workers in need, facilitating the delivery of these services in a nonstigmatising, gender-sensitive, confidential, and convenient setting when there is no staff clinic and/or their own facility does not offer antiretroviral therapy, or where healthcare workers prefer services off-site; in the context of preventing comorbidities, providing universal availability of a comprehensive package on prevention and care for all HIV-positive healthcare workers, including isoniazid preventive therapy and cotrimoxazole prophylaxis, with appropriate information on benefits and risks; developing and implementing training programmes for all healthcare workers that include preservice, in-service, and continuing education on TB and HIV prevention, treatment, care, and support, workers’ rights and stigma reduction, integrating these into existing training programmes and including managers and worker representatives; establishing and providing adequate financial resources for prevention, treatment, care, and support programmes to prevent both occupational or nonoccupational transmission of HIV and TB among healthcare workers; disseminating the policies related to these guidelines in the form of codes of practices and other accessible formats for application at the level of healthcare facilities and ensuring provision of budgets for the training and material inputs to make them operational; and developing and implementing mechanisms for monitoring the availability of the guidelines at the national level, as well as the dissemination of these policies and their application in the healthcare setting.
Keywords: HIV - Prevention, HIV - Resource-Limited Settings, HIV - Special Populations, HIV - Tuberculosis, Tuberculosis - Biomedical Prevention, Tuberculosis - Resource-Limited Settings, Tuberculosis - Transmission and Prevention