Pregnant Newcomers Denied HIV Aid in UK
By Richard Woodman
Originally published by Reuters Health, July 2, 2002
LONDON (Reuters) — HIV-positive pregnant women who have recently arrived in Britain are being denied free drugs to prevent them passing on the virus to their babies, a leading AIDS charity said.
The Terrence Higgins Trust said the policy was both "inhumane and a false economy." The drugs cost only a few pounds to health authorities, while the lifetime healthcare costs of looking after a child born with HIV could be as much as one million pounds.
Doctors treating sexually transmitted diseases also condemned the practice as "utterly appalling" and "unethical."
The Trust told Reuters it knows of several people who were denied free treatment by hospitals because they had been resident in Britain for less than 1 year.
In one case, a pregnant student from southern Africa was diagnosed with HIV at a hospital in central England. She was then questioned by more than one person from the hospital's finance department about her entitlement to care and told she would be charged 10 Pounds for her HIV test.
"She was also told she could not receive any treatment to prevent mother-to-baby transmission of HIV unless she paid the full cost of it," the Trust said. The woman then contacted the Trust, which supported her in going to another hospital, out of the area, where staff were prepared to interpret the regulations more generously.
In another case, the Trust said a woman from East Africa was diagnosed with HIV at a hospital in London where a midwife gave her some medicines unofficially but was unable to offer ongoing treatment. The woman did not come back and it was not known what happened to her.
The Department of Health said it was looking into the issue, and would comment later on Tuesday.
Dr. Adrian Palfreeman, a consultant physician treating sexually transmitted diseases and a member of the British HIV Association, said of the cited cases, "this is utterly appalling in my view, and cannot be defended. There is little point in offering somebody antenatal care and then refusing to give them the treatment they need to ensure they have a healthy baby. That is totally unethical."
He added: "My responsibility as a doctor is to treat the patient in front of me. It is no way part of my job to assess their immigration status or whether or not they should be entitled to care."
Lisa Power, the Trust's head of policy, campaigns and research, said some of those who had been refused treatment managed to obtain it at other hospitals, but that others had simply disappeared. "Hopefully, HIV was not transmitted to their children but we just don't know," she said.
Power said National Health Service rules governing treatment rights of people who have lived in Britain less than 1 year seemed illogical. On public health grounds, other sexually transmitted infections were treated free of charge, but not HIV.
The rules were made years ago when there were no effective drugs for AIDS and have never been revised, she added. The Trust said that anyone who has been in the UK for more than 12 months is entitled to free treatment whatever their immigration status. But pregnant women clearly could not wait that long.
The rules also meant that people with life-threatening HIV complications were treated in hospital accident and emergency departments but were then discharged without ongoing treatment as soon as the immediate threat was removed.
Terrence Higgins is the first person known to have died from AIDS in Britain. The Trust commemorates the 20th anniversary of his death this week—just ahead of the 14th International AIDS Conference which opens in Barcelona on Sunday.
