Partner Referral Recommendations
The CDC has evidence to suggest that most HIV infections are caused unknowingly, which is why partner referral services are essential. In brief, partner referral services is a confidential service you provide on behalf of people with HIV, so they can tell their partners (usually over phone) that they may have been exposed to HIV, either through sex or injecting drug use. The purpose of the message is to inform, recommend testing, and to seek counseling, not to give names (unless authorized to).
There are three suggested ways to get people with HIV to inform their partners: provider referral, client referral, or contract referral.
- Provider referrals: In this type of referral, a care provider speaks to the partner of the person with HIV regarding a possible HIV exposure. The provider must offer information on how to obtain HIV counseling, and how to get tested. Alternatively, studies demonstrate that is easier to have a department of health specialist call on behalf of the person with HIV (HIV Partner and Counseling Services).
- Client referrals: In this type of referral the person with HIV contacts his or her partner, and bears the burden of discussing the HIV exposure.
- Contract referral: In this type of referral, the person with HIV signs a contract stating that he or she will contact his or her partner. If the person with HIV fails to do so, the Department of Health may intervene on his or her behalf.
While your patient has the option not to inform their partners, you may, with some discretion, contact the exposed partner. There are some requirements you must adhere to if you wish to do this: the third party contact must be identified by the patient, you must recommend that the patient contact their partner, or to use the department of health to contact them, if the patient refuses, you must inform the patient you are doing so, it must be documented (you must not record partners name in the patient's records), and you must take full responsibility for adhering to the policy (providing information on how HIV is transmitted, and where the partner can get tested). If followed in good faith, you will not be held liable. Florida ultimately doesn't require medical professionals to report the status of an HIV patient, nor will it hold professionals liable for withholding that information for the purposes of patient privacy. This helps protect professionals from civil and criminal liabilities. Florida ultimately hopes for voluntary disclosure.
Patient Rights and Exceptions to the ADA of 1990
The Americans with Disabilities Act of 1990 protects HIV patients from unlawful discrimination, however, though protected by law, it is very easy for people with HIV to have their rights violated because of misunderstandings. The following piece will help explain the general rights of HIV patients. People with HIV are afforded the same rights as any other citizen in the United States. They may travel freely within the United States, can attend any school they wish, and must be allowed to apply for positions with reasonable accommodation.
People with HIV must not be denied care, housing, insurance, or regular services solely because of their condition. In addition, their HIV status must remain confidential if learned. To enforce this, the ADA sets guidelines that the states follow. These guidelines cover public assistance measures, determine damages for unlawful discrimination (fines may reach up to $10,000), and define general rights given by law.
People with HIV are under no obligation to reveal their status normally, whether it is to their employer, or another person; however, there are special circumstances in which HIV reporting can occur without penalty:
- Life or death emergencies where treatment is more prudent than confidentiality.
- When permitted by the patient in writing or though informed/implied consent.
- When discussing a patient's case to another medical co-worker during the course of treatment.
- When STI cases are reported to the Department of Health (they keep a confidential database of STI cases).
- Regular forms may ask for information, if it is applicable, but answering is completely voluntary. Any information received in the course of care is to be given only to other medical workers assigned to the person's case.
- If it is prudent for an insurance company to receive information about HIV during the course of treatment (unnecessary reporting can lead to an employer's confidentiality breach, and, potentially, the loss of work).
- Courts, for the safety of others, may make information pertaining to a case public.
- Victims of a crime, which involve bodily fluid exposure, may request that the convicted assailant be tested for HIV.
- In the event HIV diagnosis may be construed as detrimental to the well-being of a patient, formal consent is not necessary to obtain a blood test. This may not be used to bypass normal consent methods.