Acceptance situation of HIV patients in Japanese dialysis facilities―Questionnaire survey by Infection Survey Subcommittee

A newspaper article in August 2016 reported that about 40 medical facilities refused dialysis to a human immunodeficiency virus (HIV) patient. To investigate this situation, Infection Survey Subcommittee in the Japanese Society for Dialysis Therapy conducted a questionnaire survey. It was sent to 4,039 facilities, of which 2,583 facilities (64.0%) responded to the survey questions. In the past 5 years, 215 facilities (8.3%) were requested to accept HIV patients for dialysis and 40.1% of these “refused” acceptance. Although manuals, written policy and procedure, for a needle piercing accident existed in most of the facilities that accepted the patients, many facilities did neither prepare the stocks of anti-HIV drugs nor co-operate with HIV core hospitals. Principal reasons for “the refusal” were listed as the lack of medical experience with HIV patients, anxiety of healthcare providers with regards to HIV infection risk, lack of stocks of anti-HIV drugs for needle piercing accidents, and lack of cooperation with HIV core hospitals. The proportion of facilities expected to accept HIV patients in the future was as low as 16.9% among all facilities that responded to the survey. The Japanese Society for Dialysis Therapy will need to strengthen the cooperation with other academic societies and disseminate basic knowledge on HIV and its infection control measures to develop and establish the acceptance system of maintenance dialysis for HIV patients.