§ 23-6.3-3. HIV screening and testing of adults, adolescents, and pregnant women.
(a) This section shall pertain to patients in all healthcare settings and HIV CTRS sites.
(b) HIV screening and testing shall be based on the most current recommendations for HIV
counseling, testing and referral of adults, adolescents and pregnant women issued
by the CDC. Provided, however, those guidelines shall be interpreted by the department
so as to best serve the individuals and patients receiving HIV testing, and shall
in no event be interpreted or implemented in a manner inconsistent with the minimum
informed consent standards and other provisions and protections of state law and regulations.
(c) All individuals who desire anonymous HIV testing shall be referred to an HIV CTRS
site funded by the department that provides anonymous HIV testing.
(d) All healthcare settings and HIV CTRS sites shall develop protocols that include no
less than the following: assessment for individuals at high risk for HIV infection;
frequency of HIV testing; communication of HIV test results; and post-test linkages
to needed care and support services.
(e) Those adults, adolescents and pregnant women who test positive for HIV infection shall
be given priority for outpatient substance abuse treatment programs that are sponsored
or supported by the appropriate state agency responsible for these services, and those
who test negative for HIV infection shall be referred to the appropriate state agency
responsible for these services for earliest possible evaluation and treatment.
(f) A positive test result must be given in person. Persons testing positive for HIV must
also be provided with linkages and referrals to HIV-related counseling, health care
and support.
(g) All persons tested under this section shall be informed of the results of the HIV
test.
(h) Consent and providing information for HIV testing:
(1) Except as provided in § 23-6.3-4, HIV screening shall be voluntary, free from coercion, incorporated into routine
medical testing, and undertaken only with the individual's knowledge and understanding
that HIV testing will be performed.
(2) No person shall order the performance of an HIV test without first: (i) Providing
the information and opportunity for discussion or counseling set forth in this section;
(ii) Informing the patient that he or she has a right to decline testing; and (iii)
Obtaining the oral consent of the patient to be tested or of a person authorized to
consent to health care for such individual. Said consent and exchange of HIV information
shall be documented in the patient's medical record.
(3) A physician or healthcare provider may tailor HIV counseling to best meet the needs
of the individual to be tested. Decisions concerning patient-specific tailoring and
the extent of pre-test counseling shall be made on a case-by-case basis.
(4) In no event shall a patient be tested for HIV pursuant to this section without first
being provided with verbal or written information that includes the following:
(i) An explanation of HIV infection;
(ii) A description of interventions that can reduce HIV transmission;
(iii) The meanings of positive and negative test results;
(iv) The possibility that a recent infection may not be detected; and
(v) An opportunity to ask questions and to decline testing.
(i) For pregnant women:
(1) HIV screening shall be incorporated as part of routine prenatal testing for all pregnant
women as early and often as appropriate during each pregnancy after the patient has
been notified that voluntary testing, in accordance with the consent and information
requirements of subsection (h), will be performed unless the patient opts out.
(2) Any woman with an undocumented HIV test status in her record at the time of labor
and/or delivery shall be screened with an HIV test in 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 delivery without the mother's consent
if the mother's HIV status is not documented, provided that:
(i) Reasonable efforts have been made to secure voluntary consent from the mother to test
the newborn; and
(ii) A mother is informed that HIV antibodies in the newborn indicate that the mother is
infected with HIV.
(j) The department shall provide guidance and access to written information to be used
for the purposes of this section. This information shall notify the patients about
risk-reduction strategies; the merits of repeat HIV and STD testing; and the availability
of counseling and HIV prevention services. Informational materials shall be easily
understandable and made available in Spanish and in other languages as appropriate
to assure that the information presented is in a format that the individual can understand.
Interpreters and bilingual staff shall demonstrate competency in providing 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 and confidential HIV testing. To protect
the anonymity of patients tested anonymously, written consent shall not be offered
as an option to verbal informed consent in anonymous testing.
(l) In accordance with chapter 8 of this title, individuals under eighteen (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 training sessions, develop standardized
materials to support more universal testing, utilize community input to create implementation
plans, and evaluate the impact of this section.
(n) No physician or healthcare provider shall discriminate against a patient because he
or she is HIV positive or has declined to take an HIV test.