HIV testing (in California)

Background

  • Consent requirements for HIV testing from state to state
  • In California, California Health and Safety Code Section 120990 speaks to this issue

Requirements Before Ordering The Test[1]

  • Prior to ordering a test that identifies infection of a patient with HIV, a medical care provider shall:
    • Inform the patient he/she will be tested for HIV
    • Provide information about the test
    • Inform that if positive, there are numerous treatment options available
    • Inform that if negative, the patient should continue to be routinely tested
  • Advise the patient that he/she has the right to decline the test
  • Document whether the informed consent was written or verbal
  • Provide the results to the patient in timely manner with and counseling and contact for medical/psychological follow up

Difficult Situations

  • Occupational Exposure
    • The exposed has to seek evaluation by a physician (not him/herself) for evaluation to determine if "significant exposure."
    • Significant exposure "means direct contact with blood or other potentially infectious materials of a patient in a manner that, according to the then applicable guidelines of the Division of Occupational Safety and Health, is capable of transmitting a communicable disease (subdivision (h) of Section 120261.)
    • The treating physician has to certify by documenting that a significant exposure occurred
    • A test for HIV on the exposed has to be done and confirmed before a test on the source patient can be done without consent
    • The attending physician for the exposed can then test the patient without his consent
    • This test can be performed on any available blood or other tissue sample
    • If the source patient died, the source patient's blood can be obtained and tested regardless of any consenting
    • If the patient is living and there is no blood sample and the patient refuses to allow for a blood sample to be obtained, it appears that this is not permitted except as otherwise authorized by law
    • The source patient has the option not to be informed of the results
    • If he/she does not want to be informed of the results, the results cannot be documented in his/her chart
    • The exposed patient cannot directly attempt to obtain informed consent from the source patient
    • Costs of the testing will be assumed by the employer of the exposed patient
  • A medical provider can order an HIV test on a cadaver, or when autopsy will be performed, or when body parts may be donated (Section 7150)

External Links

California Health and Safety Code Section 120990

See Also

References

  1. California Health and Safety Code Section 120990