Did you know that HIV/AIDS is the fourth leading cause of death worldwide? Indeed, few diseases induce human suffering on this impressive scale. While this pandemic does appear to be reaching a peak, it’s clear we have a long way to go before its global effects can be successfully attenuated.
The fact that I’m addressing this issue on this blog leads to the inevitable question: What does HIV/AIDS have to do with vet med? And the answer? As I stated in the title: More than you think!
According to an engrossing editorial* written by public health vet Dr. Radford Davis for Compendium back in 2008 (forgive the untimeliness, I was only recently researching this topic for an HIV-positive client of mine):
HIV/AIDS is only one of the many immunocompromising diseases and conditions that afflict humans, but it is unique and demands veterinary attention for several reasons. Its many routes of transmission, the high susceptibility of people with AIDS to recurrent opportunistic infections and demonstrable zoonotic threats, the enduring myth of animal transmission, and the unique liability issues surrounding exposure and confidentiality are but a few. In the future, demonstration of HIV/AIDS education may become part of state licensing requirements for veterinarians, as it is already in Washington State.
Those with AIDS, the immunosuppressed and later stage of HIV infection, face significant health risks from zoonotic pathogens, more so than immunocompetent individuals. Veterinarians are considered experts on zoonotic diseases and, in keeping with our public health commitment, should be addressing the needs of clients with HIV/AIDS through proper education and communication. Educational measures could include explaining how clients can reduce their risk of exposure to certain zoonoses, discussing pet retention or adoption, or dispelling myths about HIV transmission: a recent survey showed that 22% of Americans still believe HIV can be transmitted by sharing a drinking glass. Sometimes, communication duties must include speaking to the physician of an HIV-infected individual to assuage concerns about the risks of owning a pet or to reverse unjust recommendations, such as getting rid of a pet.
Further, Dr. Davis insists that...
...as veterinarians and public health professionals, we must also oversee the running of a safe, threat-free workplace ... dog bites and needlestick injuries are not uncommon in a veterinary practice setting ... clients and employees who are bitten can put others at risk for exposure to bloodborne pathogens such as HIV and hepatitis B and C. Veterinarians and their staff need to know how to prevent their own exposure to these pathogens while addressing the immediate medical needs of the victim.
Allaying staff fears surrounding HIV/AIDS and ensuring that those with HIV/AIDS do not face discrimination or harassment in the workplace are other essential aspects of addressing HIV in the veterinary clinic.
But as much as I have much to be proud of in my colleagues' take on our veterinary duties to protect human life and alleviate human suffering where we can, here’s where I can really get behind Dr. D:
More than 25 years since it was first identified, HIV/AIDS is more than a health care issue, more than a disease. It affects families, communities, nations, and economies, has generated millions of orphans, and casts a shadow of fear everywhere it is found. In some countries, such as Botswana, the rate of infection is as high as one in four. As veterinarians, we can make a difference in helping those with HIV lead happier, healthier, safer lives. Veterinarians must reach out to clients with HIV/AIDS and make an effort to educate themselves on what is arguably the most important disease of our time. Our role in public health demands it.
Dr. Patty Khuly