§ 23-6.3-3 - HIV screening and testing of adults, adolescents, and pregnant women.
SECTION 23-6.3-3
§ 23-6.3-3 HIV screening and testing ofadults, adolescents, and pregnant women. – (a) This section shall pertain to patients in all health care settings and HIVCTRS sites.
(b) HIV screening and testing shall be based on the mostcurrent recommendations for HIV counseling, testing and referral of adults,adolescents and pregnant women issued by the CDC. Provided, however, thoseguidelines shall be interpreted by the department so as to best serve theindividuals and patients receiving HIV testing, and shall in no event beinterpreted or implemented in a manner inconsistent with the minimum informedconsent standards and other provisions and protections of state law andregulations.
(c) All individuals who desire anonymous HIV testing shall bereferred to an HIV CTRS site funded by the department that provides anonymousHIV testing.
(d) All health care settings and HIV CTRS sites shall developprotocols that include no less than the following: assessment for individualsat high risk for HIV infection; frequency of HIV testing; communication of HIVtest results; and post-test linkages to needed care and support services.
(e) Those adults, adolescents and pregnant women who testpositive for HIV infection shall be given priority for outpatient substanceabuse treatment programs that are sponsored or supported by the appropriatestate agency responsible for these services, and those who test negative forHIV infection shall be referred to the appropriate state agency responsible forthese services for earliest possible evaluation and treatment.
(f) A positive test result must be given in person. Personstesting positive for HIV must also be provided with linkages and referrals toHIV-related counseling, health care and support.
(g) All persons tested under this section shall be informedof the results of the HIV test.
(h) Consent and providing information for HIV testing:
(1) Except as provided in § 23-6.3-4, HIV screeningshall be voluntary, free from coercion, incorporated into routine medicaltesting, and undertaken only with the individual's knowledge and understandingthat HIV testing will be performed.
(2) No person shall order the performance of an HIV testwithout first: (i) Providing the information and opportunity for discussion orcounseling set forth in this section; (ii) Informing the patient that he or shehas a right to decline testing; and (iii) Obtaining the oral consent of thepatient to be tested or of a person authorized to consent to health care forsuch individual. Said consent and exchange of HIV information shall bedocumented in the patient's medical record.
(3) A physician or health care provider may tailor HIVcounseling to best meet the needs of the individual to be tested. Decisionsconcerning patient-specific tailoring and the extent of pre-test counselingshall be made on a case-by-case basis.
(4) In no event shall a patient be tested for HIV pursuant tothis section without first being provided with verbal or written informationthat includes the following:
(i) An explanation of HIV infection;
(ii) A description of interventions that can reduce HIVtransmission;
(iii) The meanings of positive and negative test results;
(iv) The possibility that a recent infection may not bedetected; and
(v) An opportunity to ask questions and to decline testing.
(i) For pregnant women:
(1) HIV screening shall be incorporated as part of routineprenatal testing for all pregnant women as early and often as appropriateduring each pregnancy after the patient has been notified that voluntarytesting, in accordance with the consent and information requirements ofsubsection (h), will be performed unless the patient opts out.
(2) Any woman with an undocumented HIV test status in herrecord at the time of labor and/or delivery shall be screened with an HIV testin accordance with the consent and information requirements of subsection (h),unless she opts out.
(3) A newborn shall be tested as soon as possible at deliverywithout the mother's consent if the mother's HIV status is not documented,provided that:
(i) Reasonable efforts have been made to secure voluntaryconsent from the mother to test the newborn; and
(ii) A mother is informed that HIV antibodies in the newbornindicate that the mother is infected with HIV.
(j) The department shall provide guidance and access towritten information to be used for the purposes of this section. Thisinformation shall notify the patients about risk-reduction strategies; themerits of repeat HIV and STD testing; and the availability of counseling andHIV prevention services. Informational materials shall be easily understandableand made available in Spanish and in other languages as appropriate to assurethat the information presented is in a format that the individual canunderstand. Interpreters and bilingual staff shall demonstrate competency inproviding language assistance to patients with limited English proficiency.Family or friends shall not be used as language interpreters.
(k) A distinction shall be made between anonymous andconfidential HIV testing. To protect the anonymity of patients testedanonymously, written consent shall not be offered as an option to verbalinformed consent in anonymous testing.
(l) In accordance with chapter 23-8, individuals undereighteen (18) years of age may give legal consent for testing, examination,and/or treatment for any reportable communicable disease, including HIV.
(m) The department shall initiate medical provider trainingsessions, develop standardized materials to support more universal testing,utilize community input to create implementation plans, and evaluate the impactof this section.
(n) No physician or health care provider shall discriminateagainst a patient because he or she is HIV positive or has declined to take anHIV test.