CONNECTICUT - ACQUIRED IMMUNODEFICIENCY SYNDROME (AIDS) AND HUMAN IMMUNODEFICIENCY VIRUS (HIV)

March 14, 2008

State laws and regulations that affect your medical practice

1. Must physicians report the diagnosis and the treatment of AIDS or HIV to the Department of Health, HIV/AIDS Surveillance Program?

Yes. Newly diagnosed cases of HIV infection and AIDS are required to be reported to the Department of Public Health, HIV/AIDS Surveillance Program.

HIV and AIDS cases are reported using the same form: Adult HIV/AIDS Confidential Case Report Form. Call the HIV/AIDS Surveillance Program at (860) 509-7900 to obtain forms. Be sure to obtain infection risk information. HIV reporting has been expanded to include information on testing history.

Mail the completed case report form to the following address:

Connecticut Department of Public Health
410 Capitol Ave MS #11ASV
PO Box 340308
Hartford, CT 06134-0308

The envelope should be marked “CONFIDENTIAL.” Patient consent is not required for reporting. Reporting and surveillance activities are not subject to HIPPA restrictions.

Connecticut Department of Public Health

2. Must a physician obtain informed consent from a patient before testing for HIV?

Yes. No “HIV-related test” may be conducted without either 1) written consent; or 2) oral consent which has been documented in a medical record.

C.G.S.A. § 19a-582

3. What if the patient is a minor?

The consent of a parent of guardian shall not be a prerequisite to HIV-related testing of a minor. At the time a minor receives the test result, if tested without parental consent, counseling must be provided towards the goal of involving the minor’s parents. The minor must receive counseling about the need to notify partners.

C.G.S.A. § 19a-582

4. Whatprocedures must be followed in communicating test results to patients?

At the time of communicating the test result, the subject of the test shall be provided with counseling or referrals for counseling: (1) for coping with the emotional consequences of learning the result; (2) regarding the discrimination problems that disclosure of the result could cause; (3) for behavior change to prevent transmission or contraction of HIV infection; (4) to inform such person of available medical treatments; (5) to work towards the goal of involving a minor’s parents in the decision to seek and in the ongoing provision of medical treatment; (6) regarding the need of the test subject to notify his/her partners, except that if the patient is a minor who was tested without the consent of his/her parents, such counseling shall be provided at the time of communicating the test results to him/her.

A health care provider shall not withhold test results from the patient. If the patient refuses to receive his/her test results, the health care provider should encourage the patient to receive the result and to adopt behavior changesthat will allow him/her to protect others from infection.

C.G.S.A. § 191-582(b)

5. Do physicians have a duty to warn third parties of a patient's AIDS or HIV infection?

A physician may warn or inform a known partner of a patient if both the partner and the patient are under the physician’s care or the physician may disclose confidential HIV-related information to a public health officer for the purpose of informing or warning partners of the patient that they make have been exposed to HIV, under the following conditions:

(1) The physician reasonably believes that there is a significant risk of transmission to the partner;

(2) The physician has counseled the patient regarding the need to notify the partner and the physician reasonably believes the protected individual will not inform the partner;

(3) The physician has informed the protected individual of such physician’s intent to make such disclosure to the partner or public health officer.

The physician must also warn or inform a partner at the request of a patient. When making such disclosure to the partner the physician shall provide or make referrals for the provision of the appropriate medical advice and counseling for coping with the emotional consequences of learning the information and for changing behavior to prevent transmission of HIV infection.

The physician shall not disclose the identity of the patient or the identity of any other partner, except where circumstances reasonably prevent doing so. The physician shall make such disclosure in person, except where circumstances reasonably prevent doing so.

C.G.S.A. § 19a-584(b)

6. Must a physician inform a patient of the physician's own HIV infection or AIDS condition?

The courts are still attempting to define the rights of health care workers with HIV, especially those who perform invasive procedures. In New Jersey, the Superior Court held in Estate of William Behringer, M.D. v. The Medical Center at Princeton, 249 N.J. Super. 597 (Law Div. 1991), that an HIV-infected physician must disclose his or her HIV status to patients, in keeping with the commitment of New Jersey courts to the concept of informed consent. The New Jersey court's disclosure requirement seems to apply to all physicians, regardless of specialty or whether any invasive or exposure-prone procedures will be performed.

Similarly, in Doe v. University of Maryland Medical System Corporation, 50 F. 3d 1261 (1995), the U.S. Court of Appeals, Fourth Circuit held that an HIV positive surgeon could not allege violations of the Americans with Disabilities Act (ADA) for his suspension from surgical duties because he posed a significant risk to patients through percutaenous injury that could not be eliminated by reasonable accommodation.

Since this area of law is unsettled, an HIV-positive health care worker should consult with his/her attorney.

Copyright © Kern Augustine Conroy and Schoppmann, P.C. Used with permission.

Updated 2008