by Rachel Pollock, Marketing and Brand Specialist,
Tanya Babitch, Assistant Vice President of Risk Management, and
Robin Desrocher, Director, Risk Management
Answers to your questions about testing patients for sexually transmitted infections (STIs).
What types of STIs require health care providers to notify the state?
Texas Law and Administrative Code requires health care providers to report the following sexually transmitted infections: HIV and AIDS, syphilis, chlamydia, gonorrhea, chancroid, and hepatitis C. More information regarding how reporting and testing and treatment guidelines is available on the Texas Department of State Health Services website.
What type of consent is required for HIV testing?
Except as otherwise provided by law, a person may not perform an HIV test without first obtaining the informed consent of the person to be tested. This consent does not need to be written. Documentation in the medical record that the test has been explained and consent has been obtained is sufficient. For more information on HIV testing consent, please review the Texas Health and Safety Code Sec. 81.105.
Can I test a patient for HIV after one of my employees has been accidentally exposed?
In a case of accidental exposure to blood or other body fluids, a health care facility or agency may test the person who may have exposed the health care worker to HIV without the person's specific consent to test. Certain protocols must be followed, and any identifying information concerning the person should be destroyed as soon as the testing is complete and the person who may have been exposed is notified. See Texas Health and Safety Code Sec. 81.107.
Can I test for HIV before a procedure?
Texas law provides that a physician may require a patient to have an HIV test if a medical procedure is to be performed that could expose health care personnel to AIDS or HIV infection, and there is sufficient time to receive the test result before the procedure is conducted.
However, HIV-positive patients are protected under the Americans with Disabilities Act (ADA), which supersedes state law. The ADA also prohibits discrimination against persons who are perceived to have a disability. Thus, refusing to perform a procedure based on HIV status or the patient's refusal to undergo an HIV test would likely violate the ADA.
Does the Americans with Disabilities Act (ADA) require me to treat individuals with HIV?
While the ADA expressly provides that a public accommodation may exclude an individual if that individual poses a “direct threat” to the health or safety of others that cannot be mitigated by appropriate modifications in the accommodation policies or procedures, one cannot justify the refusal to treat HIV-positive or AIDS patients in the policies of organized medicine or public health. Health care providers may not generally refuse care or refer a patient with HIV or AIDS to another provider simply because the person has HIV or AIDS.
The Centers for Disease Control and Prevention and the American Medical Association recommend the use of “universal precautions” to prevent the transmission of blood-borne diseases in the health care setting. More information is available in the TMLT Reporter articles, 2016- Quarter 2 and Quarter 3, Treating and accommodating patients under the ADA, parts 1 and 2.
Am I required to offer counseling when a patient has a positive HIV test result?
Yes. Texas law requires patients be offered individual, face-to-face post-test counseling about the meaning of the test result, measures to prevent transmission, and other elements.
What is expedited partner therapy (EPT)?
Physicians are allowed to prescribe treatment for the sexual partner(s) of their established patients who have been diagnosed with chlamydia or gonorrhea without establishing a professional relationship with the partner first. Please see The Texas Department of State Health Services EPT resources for more information.