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

• 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

• HIV - AIDS (Main)
• HIV post-exposure prophylaxis

References

Authors

Trevor C. Wilson, Neil Young, Ross Donaldson