HIV/AIDS and the Food Handler

July 2022

Health authorities around the world all agree that transmission of HIV/AIDS via food and beverages is not a known risk. This situation needs to be made clear to all employers and employees in all areas of the food and drink sector, as well as to the consuming public. It needs to be emphasised to individuals with HIV/AIDS that they must comply with the food hygiene and safety requirements applicable to all food handlers. They may be more likely than others to suffer from diarrhoeal diseases that can be transmitted by food, and other infections or lesions. In these cases, in the UK, food handlers should be managed according to ‘Food Handlers: Fitness to Work’ guidelines issued by the Food Standards Agency (FSA).

The problem

The disease AIDS (Acquired Immunodeficiency Syndrome) is caused by a group of viruses called HIV (Human Immunodeficiency Virus) which damage the immune system, making the patient more susceptible to secondary infections, especially diarrhoeal diseases, lung infections and cancers. Millions of people around the world are thought to be infected with the virus with numbers increasing rapidly, hence it is inevitable that some of these sufferers will be food handlers.

The US Centers for Disease Control and Prevention (CDC) statement confirms that there is no known risk of transmission of blood-borne and sexually transmitted infections, such as HIV/AIDS, during the preparation or serving of food or beverages, stating: ‘There is no known risk of HIV transmission to co-workers, clients, or consumers from contact in industries such as food-service establishments (see information on survival of HIV outside the body). Food-service workers known to be infected with HIV need not be restricted from work unless they have other infections or illnesses (such as diarrhoea or hepatitis A) for which any food-service worker, regardless of HIV infection status, should be restricted. CDC recommends that all food-service workers follow recommended standards and practices of good personal hygiene and food sanitation.

There have been no documented instances of transmission of HIV/AIDS in this way. It is therefore important that the food industry, the consuming public and the media all understand that transmission of HIV/AIDS by food and beverages is not a risk, however, people with HIV/AIDS are more likely than others to suffer from diarrhoeal diseases that can be transmitted by food, and other infections or lesions. In this event, the food handlers should be managed according to the guidelines issued by the Food Standards Agency (FSA), namely ‘Food Handlers: Fitness to Work’.

The virus and mode of spread

AIDS is caused by one or more of a group of retroviruses, which for simplicity have all been called HIV. Human beings should be regarded as the sole reservoir of the virus. Neither foodstuffs (including food animals), animals, pets, nor insects are sources. HIV is spread by sexual contact with infected persons, injection of contaminated blood, or blood products, and by transmission from mother to child. HIV cannot be spread by touching, coughing, sneezing or insect bites. The virus has an incubation period of 5-8 years and so the progress of the disease varies from person to person. Some people can unwittingly carry the virus without showing any symptoms, although it seems probable that all HIV carriers will develop AIDS. While there's no cure for HIV, there are very effective treatments that enable most people with the virus to live a long and healthy life. Antivirals can extend the life of individuals, provided they also adopt a healthy diet and take precautions to protect themselves from illness and infection.

Survival of the virus outside the human body

The virus dies only slowly at room temperature and will survive well when frozen, however, it is very sensitive to heat and is rapidly destroyed at, or above, 55oC. It is readily inactivated at both low and high pH. The HIV virus is rapidly destroyed by commonly used concentrations of all biocides, including hypochlorite, ethyl alcohol and isopropyl alcohol. When accidents occur, the precautions used to prevent the spread of viral hepatitis, and other blood-borne infections will also prevent the spread of HIV. First aiders should cover any exposed cuts or abrasions on their own hands with a waterproof dressing and wear disposable plastic gloves and an apron. Spillages of blood and other body fluids should be flooded with a biocide and mopped up with paper towels. All these disposable items should be placed in plastic bags and safely disposed of, preferably by incineration. 

Implications for the food industry

Food handlers who carry HIV are not a threat to their colleagues, or to the products that they handle. They should not be restricted from working with foods or beverages or be restricted from using telephones, machinery, office equipment, toilets, showers, eating facilities or drinking fountains. They may therefore work normally, unless, of course, they develop a secondary infection, such as a diarrhoeal disease, which will preclude them from handling food. As mentioned previously, in such circumstances, the employee and employer should follow FSA guidelines (Food Handlers: Fitness to Work. Regulatory Guidance and Best Practice Advice for Food Business Operators, 2009).

Ethical considerations

As no cases of HIV/AIDS transmission have been identified through food or food handling, then the key aspect is that people who identify as having HIV/AIDS are not negatively impacted as a result of having the disease. Legislation across the world makes discrimination on the basis of the disease an offence, hence employers should take on board any requirements to ensure staff are not impacted whilst working, including confidentiality where applicable, discrimination policies enacted, rigorous prevention of bias, and a programme of talking about the disease to explode the myths.

It is common in the poorest countries for the nutrition of food handlers, including agricultural workers, with HIV/AIDS to be an issue. This has been identified by UNAIDS HIV, Food Security and Nutrition (May 2008), as a key consideration for international government policy, as it negatively affects food security, if not planned for. In all cases, food programmes, and other aspects are seen through the HIV/AIDS lens, should be applied to establish the best management methods.

References
  1. Food Standards Agency (2009) “Food Handlers: Fitness To Work. Regulatory Guidance and Best Practice Advice for Food Business Operators
  2. NHS Plus (2008) “Infected Food Handlers: Occupational aspects of Management
  3. Regulation (EC) No 852/2004 On the Hygiene of Foodstuffs. Annex II Chapter VIII
  4. US Centers for Disease Control and Prevention, Divisions of HIV/AIDS ‘’HIV Transmission’’ (Accessed on: 27/01/2022)
  5. US Department of Health and Human Services (HHS)
  6. US Food and Drug Administration, Food Code 2017: Chapter 2 - Management and Personnel (Accessed on: 27/01/2022)
  7. CDC: HIV - Stigma and Discrimination (June 2021) https://www.cdc.gov/hiv/basics/hiv-stigma
  8. UNAIDS Policy Brief: HIV, Food Security and Nutrition (May 2008) https://www.unaids.org/sites/default/files/media_asset/jc1515_policy_brief_nutrition_en_1.pdf

Institute of Food Science & Technology has authorised the publication of this Information Statement on HIV/AIDS and the Food Handler. 

This is an update to the Information Statement that has been prepared by Christine Morrison CSci MIFST. It has been peer-reviewed and approved by the IFST Scientific Committee. 

This information statement is dated July 2022.

The Institute takes every possible care in compiling, preparing and issuing the information contained in IFST Information Statements, but can accept no liability whatsoever in connection with them. Nothing in them should be construed as absolving anyone from complying with legal requirements. They are provided for general information and guidance and to express expert professional interpretation and opinion, on important food-related issues.