Dáil Éireann debate -
Wednesday, 21 Oct 1992

Vol. 424 No. 1

Written Answers. - HIV Surveillance System.

Nora Owen

Question:

48 Mrs. Owen asked the Minister for Health the proposals, if any, he has for anonymous blood-testing for HIV in our hospitals; the costs, if any, involved in this; when the first results will be available; the follow up, if any, which is possible for alerting potential sufferers of their condition.

Edward Nealon

Question:

51 Mr. Nealon asked the Minister for Health the proposals, if any, he has to have blood-testing carried out in hospitals for HIV diagnosis; when the process will commence; and if the patient will have the option of knowing the results.

Brendan Howlin

Question:

118 Mr. Howlin asked the Minister for Health if he has authorised the testing of blood samples of hospital patients for AIDS; if so, if the consent of patients is requested for such tests; if the results of any such tests are made available to patients; and if he will make a statement on the matter.

Minister for Health (Dr. O'Connell)

I propose to take Questions Nos. 48, 51 and 118 together.

At present, a voluntary, linked HIV surveillance system is in operation under which a person can establish his or her HIV status. Under the system a blood test is taken and this is analysed for the presence or otherwise of the infection. The person is counselled before the test is taken and informed about the implications of a positive test. In the event of a positive HIV test, the person is again counselled and is advised about the management of their condition, the care and management services available and methods to reduce the risk of spreading the infection. The service is available from a range of outlets, including sexually transmitted disease clinics, general practitioners, general hospitals, the AIDS Resource Centre, Baggot Street, community-based GP clinics for HIV and the Drug Treatment Centre, Pearse Street, Dublin 2.

The HIV surveillance system is currently used for the monitoring, by the Department of Health, of the spread of the infection, on the basis of monthly statistics submitted by the Virus Reference Laboratory, UCD. The laboratory is the national centre for confirmatory HIV testing and all HIV tests which show up as positive in the initial test are referred to the laboratory for confirmation. Under this surveillance programme, the Department monitors the spread of the infection under a number of classification groupings as follows:

—Heterosexuals;

—Intravenuous Drug Users;

—Children at risk of contracting the infection;

—Homosexual/Bisexual;

—Haemophiliacs and Haemophiliac contacts;

—Needlestick/Occupational Exposure;

—Blood Transfusions;

—Blood Donors and

—Organ Donors.

A total of 63,118 HIV tests have been undertaken for HIV antibodies to date and of these a total of 1,283 have tested positive.

The Department of Health also monitors the prevalence and incidence of cases of, and deaths from AIDS in Ireland, on a monthly basis. To date a total of 294 cases of AIDS have been reported to the Department and, of these, a total of 129 have died.

While the present system is considered to be adequate to evaluate general trends in the incidence of AIDS and HIV, the National AIDS Strategy Committee, of which I am Chairman, recommended in April 1992 that more comprehensive and accurate information is required on the spread of HIV infection in the community generally as a basis for the planning and evaluation of relevant services and programmes. The Committee established a Sub-Committee on AIDS/HIV Surveillance and Epidemiology and requested it to make recommendation on the contents and implementation of such a mechanism.

The committee has now recommended that the HIV surveillance programme should be extended, on a phased basis, to involve the anonymous, unlinked batch screening of surplus blood specimens given voluntarily by patients for necessary clinical tests.

I have decided to introduce the first part of the programme recommended by the committee i.e. anonymous screening at antenatal clinics, with effect from Monday, 26 October 1992 and will make decisions in regard to the other areas recommended in the near future.

As the framework for implementing the programme is largely in place, the cost of implementing the programme are not expected to be significant.

The programme is a necessary statistical/epidemiological exercise to ensure that the appropriate and relevant services and programmes are put in place to respond effectively and efficiently to the AIDS/HIV problem. The blood specimens used are surplus to their original requirements and, by the nature of the programme, are anonymous and unlinkable to the persons who donated them. As I mentioned at the outset, there is a comprehensive programme of individual HIV-testing already in place, which includes the essential element of one-to-one counselling, and through which individuals can establish their HIV status.